Private Test Request Form

Thank you for choosing DriverCheck!

To ensure accuracy of your request, please complete all relevant fields in this form.

Please also note that you are required to pay for your testing over the phone by Credit Card before we are able to secure an appointment for you. Drug testing prices range from $125 to approximately $400 per service (depending on service and location).

Permission to release results will be signed at time of testing.

Private test appointments will take place Monday to Friday 8:30 to 2 PM local time.

Please be aware that all private testing will not be subjected to a Medical Review or interpretation of results.

It is the sole responsibility of the individual requesting the testing to determine the appropriate testing suitable to their situation and requirements. DriverCheck will not be held responsible for any decisions an individual makes regarding the selection of testing to be performed.

DriverCheck will perform testing as requested in this form and disclaims any liability with respect to the selection of testing or testing that has been incorrectly requested.

Your results will be emailed to you encrypted. Your password consists of a combination of your DOB, the first initial of your last name and date of testing event. Example: DDMMYYYYSDDMMYYYY

Thank you,

DriverCheck Booking Department

Please provide the following information to us in order to book your private test: Full Name

Phone Number (please enter phone number with no dashes)

Date of birth (DD/MM/YYYY)

Email address

Location

Location Please enter city and/or clinic name. For multiple location options, please select 'Add another response'.

Province or Territory

Preferred date and time

Please enter the date and start and end time of availability for your appointment. For additional windows of time available, please click 'Add another response'. **Private test appointments take place at or before 2 PM local time only.

Date (Monday to Friday)

Start time available (8:30-2)

End time available (2pm)

Private Test Request Form

Testing