Upon submission of this form I acknowlegdge that my card will be charge $85.00 for a 12 panel drug test and background check.
I understand that I will receive an email within 24 hours with an attached document with information regarding where to take my drug test and the results of my background check.
I understand that this test is NON-REFUNDABLE.
NATIONAL BACKGROUND AND DRUG SCREENING CONSENT FORM
CURRENT ADDRESS (PLEASE INCLUDED CITY, STATE & ZIP
MIDDLE NAME (If no middle please type NONE)
YOUR CARD WILL BE CHARGED
Drug & Alcohol Testing Center
TEL : (404) 963-5767 FAX: (866) 485-7070 email: email@example.com