Make An Appointment

Complete the following information and one of our representatives will contact you to set up a time that is convenient for you.

*  Required information

 
  Company Info:  
Company Name:*
Address:*
City:*
State:*
Zip/Postal Code:*
Work Phone:*
Work Fax:*
 
  Contact Info:  
First Name:*
Last Name:*
Email:*
Mobile Phone:*
 
  Billing Info:  
 
  
 
Address:*
City:*
State:*
Zip/Postal Code:*
Billing Instructions:*

Please provide any special requirements needed to get invoices processed.
 
  Requested Service:  
Service Location:*
 
Service Required:*
  
  
  
  
  
  
  
  
 
Location & Time:*
  
  
  
  
 

A-Dependable Drug Testing would like to thank you for choosing our company to provide you with all the services listed above. By submitting this form you are agreeing to the pricing listed above. If you want to set up a charge account you are also agreeing to pay all invoices within 30 days of receipt. If payment is not received in that time a service charge of 1.5% will be added to the bill. If accounts become more than 90 days past due, your account will be cancelled. We accept all major credit cards. Credit card charges will be subject to a 3% processing fee.

 
 
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