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Drug Testing Device Order Form

* These items noted with the * must be filled out to process this request.
*Company Name:
*E-mail Address:  
Only Required if Different from Previous Order.
Contact Name:  
Contact Phone Number:  
Address:
 
Please provide the following information:
Type of Device Ordered: I-Cup

If Not iCup, Describe:

Panel you wish to order:
 (i.e. 2-panel, 3-panel, 5-panel, etc.)
Number of testing devices you wish to order
(in units of 25):
QED Alcohol Testing Devices:
Number Ordered (in units of 10):
Please specify if this order will need to be shipped ASAP: 
(Note: Overnight shipments cost substantially more than ground rates)

* These items noted with the * must be filled out to process this request.
 
 
     
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Faq's ~ Sample Employee Drug Testing Policies


 

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