Please confirm your details and complete the additional information below. NOTE: You will receive a confirmation email and text after you have registered that will contain your Drug screen Appointment Confirmation. IF YOU DO NOT RECIEVE THE CONFIRMATION OUTLINED ABOVE, THEN YOU DO NOT HAVE AN APPOINTMENTHiddenTodays Date MM slash DD slash YYYY HiddenDecimal TimeHiddenMin TimeHiddenVisit Auth Code HiddenVisit Details– Fill Out Other Fields –pull in visit details from visit screenHiddenCompanyIDHiddenRecipient Name First Last HiddenPhoneHiddenEmail HiddenCompany Name HiddenClinic iD single clinic HiddenDrug screen Allowed ClinicsPlease verify the details below: Employer: Name: Cell No: Email: If this is not correct, please contact the front desk when you arrive.Select Clinic for Drug Screen— Select from clinics set by employer —Melissa Hwy 5ArlingtonWichita FallsPrincetonHaslet FM156Haslet Avondale US287SouthlakeMcKinneyMelissa on Hwy 121LantanaTelemedProsperCrossroadsHeathMansfieldMidlothianDrug Screen Visit Date(Required)09/05/202309/06/202309/07/2023Select a Drug Screen Appointment Time(Required)8:00am9:00am10:00amEnter your home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Enter your Social Security Number(Required)
