Referral For Occupational Testing Call us at 888-273-0143 or fill out the below form to book now! Referral for Occupational Testing - Nov 2023 Employer Contact Details Company * Address * Contact Name * Email * Phone Number * Requested Appt Date * Reason * Pre-Employment Return to Duty Pre-Access Annual Random Reasonable Cause Post Incident / Accident OtherOther Employee Information Full Name * Phone * Email * Date of Birth * Health Card # Position * Location * Type of Service Please check if DOT Test Please check if DOT Test Level of Physical Demand * Light Medium Heavy Very Heavy Type of Service * Drug Test: Urine Drug Test: Oral Drug Test: Hair Fitness Test Audiometry Spirometry Nurse Medical Physician Medical Mask Fit (Quantitative) Driver's Abstract Criminal Check ECG Stress Test PDA FCE/FAE ECG Return to Work Coordination Substance Abuse Professional Back Assessment Oral swab for THC if detected in urine Mask Fit (Qualitative) Ergonomics Assessment Mine Rescue Medical Alcohol Test Urinalysis Check blood glucose if detected in urinalysis Xray 2 View Chest or other Blood work CBC standard otherwise please specify Site Audits Medical Station & Process Drug/Alcohol Process Occupational Health & Safety Compliance Additional drugs to be tested other than Standard 10 Panel OtherOther Check all that apply. If you are unsure please call us direct Xray 2 View Chest or other Blood work CBC standard otherwise please specify Additional drugs to be tested other than Standard 10 Panel If you are human, leave this field blank. Submit