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
FlexLab Testing - Drug Test
*
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5 Panel - Drug Test
5 Panel Drug Test (THC, COC, AMP, OPI, & PCP) with fast on-site collection and immediate results, available for pre-employment, random, and reasonable suspicion testing.
$
45.00
Quantity
1
2
3
4
10 Panel - Drug Test
10 Panel Drug Test (THC, COC, AMP, OPI, PCP, AMP, BZO, BAR, MTD, PPX, & METHQ) with fast on-site collection and immediate results, available for pre-employment, random, and reasonable suspicion testing.
$
50.00
Quantity
1
2
3
4
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
I understand that an invoice for mileage at $0.62 per mile 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
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