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To request an offsite drug test, follow both steps below:

You must complete BOTH step 1 AND Step 2 below!

Your clinic pass will be sent to the email you provide within 24 hours.

STEP 1: PAY $40

After making your payment, you MUST return to this page to complete step 2 below.

Pay by Cash APP Pay by Venmo

STEP 2: SUBMIT FORM

Only fill out the form below after completing the payment in step 1.

Name*

Date of birth*

Email*

Preferred clinic location (city and state)*

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