Drug Test Order Form

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

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*
MM slash DD slash YYYY

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).*
CAPTCHA