Drug Screen STAFF

5 Panel Drug Screen: $20
12 Panel Drug Screen: $45

"*" indicates required fields

Drug Screen CHOOSE DATE

Drug Screen CHOOSE TYPE

Clear

Drug Screen STAFF

First Name*

Last Name*

Date of Birth*

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*

Enter Email Confirm Email

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

If yes, how many?

Product Name