Drug Test Order Form

Use this form to request assistance from the TADTS Client Services team in scheduling a drug test.

"*" indicates required fields

Company Name*

Enter your company name.

DOT #*

Company DOT number.

Your Name*

First Last

Donor's Name if different than yours

First Last

If you are not the donor, provide name of person needing the test

Driver's License State of issuance*

What state is the driver license of the person beign tested issued from?

Driver's License #*

Enter the full driver license number (numbers and letters).

Date of Birth*

Date of Birth of person taking the test.

Phone*

Enter the contact telephone number of the person taking the test.

Mobile Phone / Alternate phone

Your Email Address*

Enter your email address. We will send the test authorization form (donor pass) to this email address.

City, State and Zip code*

City State Zip

Enter the City, State and Zip code where the driver will be to take the drug test.

Requested Test*

Choose which test you need performed.

DOT Mode*

Reason for Test*

Select the Reason for Test

Signature Required - By signing this form you are authorizing TADTS to schedule a drug test for the driver indicated on the form. You accept responsibility for payment of the test(s).*

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