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Requested Testing
Substance Abuse Panel 10AE (includes: Alcohol, Amphetamines Barbiturates, Benzodiazepines (Valium), Cocaine, Ecstasy, Marijuana, Methadone, Opiates (Codeine),Phencyclidine, and Propoxyphene (Darvon)) $35.00
SAP 10 + Nicotine $44.00
Informed Consent and Payment Agreement
I hereby consent to allow the student named above to undergo urinalysis testing for the presence of illicit drugs. I understand that the results of this testing will be reviewed by the Medical Review Officer of Sport Safe Testing Service, Inc., certified, and released to me. I hereby release Sport Safe Testing Service, Inc. and it’s employees from any legal responsibility or liability for the release of such information and records. I acknowledge I will be billed for the above tests by Sport Safe Testing Service, Inc. and pledge to remit my payment in a timely manner. Note to Parent: By submitting this form you are giving your consent and agreement to this program.
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Call Us : 614-847-0847
Call Us : 614-847-0847
