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ON-SITE DRUG TESTING - ORDERING AND PRICING INFORMATION

1) Company Information:

Company Name:
Subscriber Code (if applicable):
Your Name:
Position:
Address:
Phone:
Fax:
Email:
Today's Date:

Tax Exempt?  Yes No

2) Please select from the following menu:

PRODUCT
NUMBER

DESCRIPTION

KIT
SIZE

PRICE
each

PRICE*
per kit

SHIPPING

QUANTITY*
of kits ordered

 0764817

OnTrak TESTCUP 5
(5 Panel Test)

25 Cups
(125 Tests)

$22

$550

$5

 47518

OnTrak TESTCUP 4
(4 Panel Test)

25 Cups
(100 Tests)

$19

$475

$5

 47464

On-Site Alcohol Kit

50 Tests

$3.86

$193

$5

 47244

Temperature Strips

100

$0.22

$22

$3

 42210

Disposable Gloves

50 Pair

$0.50

$25

$3

* Quantity Discounts and Individual Product Orders Available, please call for details.

Please Include Chain of Custody Forms with my Order

 

After clicking Submit Order, a customer service representative will contact you for confirmation and billing information.

 

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