Drug Screen STAFF

4 Panel Drug Screen: $20
12 Panel Drug Scren: $45

"*" indicates required fields

Drug Screen CHOOSE DATE

Drug Screen CHOOSE TYPE

Clear

Drug Screen STAFF

First Name*

Last Name*

Date of Birth*

Month

Day

Year

Court*

Are you an MDOC client or a Private client?*

MDOC Client

Private (non-MDOC) Client

Please enter your MDOC number:*

Probation Officer Name*

Case Number

Your Email Address*

Your Zip Code*

ZIP / Postal Code

Your Phone Number*

B.A.C. (if it was an alcohol offense)

Do you have any prior offenses?

yes

no

If yes, how many?

Product Name

Δ

Drug Screen STAFF quantity

0

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