Suggested Testing Date & Time
Please select the date and time for testing. The testing process will take approximately 30 to 60 minutes, depending on the number of tests requested and if the donor can produce a quality sample.
Appointment
*
Company's DER
Results will ONLY be sent to the DER (Designated Employer Representative).
Company's Name
*
Please enter a valid phone number.
DER's Name
*
First Name
Last Name
Phone Number
*
Direct number we can contact while testing. This will NOT be shared with the employee completing the test.
Email
*
This is the email that results will be sent to.
Testing Address (Or Area/City):
*
Employer Drug Testing Handbook
Learn more about our policies and procedures.
Click the link below to view our employer drug testing:
FlexLab’s Employer Drug Testing Handbook
Donor #1's Information
The employee completing the drug test.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
Type Of ID:
*
Please Select
Drivers License
Military ID
Passport
ID Number
*
Reason For Test:
*
Please Select
Pre-Employment
Random
Post-Accident
Reasonable Suspicion
Periodic
Type Of Test
*
Please Select
5 Panel Drug Test
10 Panel Drug Test
Donor #2's Information
The employee(s) completing the drug test.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
Type Of ID:
Please Select
Drivers License
Military ID
Passport
ID Number
Reason For Test:
Please Select
Pre-Employment
Random
Post-Accident
Reasonable Suspicion
Periodic
Type Of Test
Please Select
5 Panel Drug Test
10 Panel Drug Test
Donor #3's Information
The employee(s) completing the drug test.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
Type Of ID:
Please Select
Drivers License
Military ID
Passport
ID Number
Reason For Test:
Please Select
Pre-Employment
Random
Post-Accident
Reasonable Suspicion
Periodic
Type Of Test
Please Select
5 Panel Drug Test
10 Panel Drug Test
Donor #4's Information
The employee(s) completing the drug test.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
Type Of ID:
Please Select
Drivers License
Military ID
Passport
ID Number
Reason For Test:
Please Select
Pre-Employment
Random
Post-Accident
Reasonable Suspicion
Periodic
Type Of Test
Please Select
5 Panel Drug Test
10 Panel Drug Test
I understand that an invoice for mileage and the drug tests will be sent separately and must be processed before the test(s) can be completed.
*
Please Select
Yes
No
I acknowledge and agree to FlexLab’s Employer Drug Testing Policies.
*
Please Select
Yes
No
Signature
DateTime
Continue
Continue
Should be Empty: