One-Time Setup Request

One-time setup tests are offered by TEAM for donors who need to test outside your company’s standard network.  You may request a one-time setup by completing the below form in its entirety.  

NOTICE:  One-time setups for Pre-employment, Random, Return to Duty, Pre-access or Follow-up will be setup either by scheduling electronically or mailing a testing kit to the donor with a donor pass and instructions on where to test.  If a kit is mailed, the charge will be postage of choice plus $15 for the one-time setup.  Post-Accident and Reasonable Suspicion will be completed within 2 hours by  either scheduling electronically or through a clinic altered chain of custody form.  If a chain is altered for a post-accident or reasonable suspicion test, the charge will be a $35 flat rate fee plus any alteration fee charged by the clinic as a pass through fee.



* Denotes required field.

Company Information








Donor Information














Drug Information


Reason for test *

Pre-Employment
Post-Accident
Random
Reasonable Suspicion
Recertification - Physical ONLY
Return to Duty
Follow-up
Other

Test Type *
(Click all that apply)

None
DOT lab test
FMCSA
PHMSA
USCG
FAA
NON-DOT Lab Test
Instant Urine Drug Test
5-panel
10-panel
Hair Test
5-panel
5-panel with Exp. Opiates

Physicals *

Yes
DOT
Non-DOT
No


Special Exam *
(Click all that apply)

None
Full Face PFT Test
Audiogram
Fit Test
Functional Capacity Exam
Other

Please Specify:

Breath Alcohol *

Yes
DOT
Non-DOT
No

Cotinine *

Yes
No

Shipping Options *

Standard Shipping
Expedited Shipping (Additional fees will apply)
Overnight Shipping (Additional fees will apply)