Drug Test Order Form

If you are at this page and did not get directed here from our order form please go HERE and place your order first.

If you have questions about the information that is needed for ordering the test or what type of test you need to order, you can call our office at 423-641-0833.

To place an order for a drug test.

Carrier Name*
Name of the carrier that this test is being ordered for.
Carrier Email*
Type of Test*
- Pre-Employment
- Random
- Post Accident
- Returned To Duty - Observed - Additional $10
- Reasonable Suspicion - CALL THE OFFICE - 423-641-0833
There is an additional $10 for observed tests. Only order this if instructed to by a Substance Abuse Professional.
Drivers First and Last Name as it appears on Driver License*
First Last
It is important that this matches the drivers license. The testing center will not administer the test if this does not match.
Drivers License Number*
State of Issue*
State
Driver Phone #*
Drivers Date of Birth*
Date Format: MM slash DD slash YYYY
Drivers Email Address*

This is where we are going to send the testing form to.
Zip Code For Testing*