Participate In Program Client Testing Collector Notice

Authorization Form

Agency Information:

,

Collection Questions?
Call ParticipateInProgram
Norton Medical Industries
at 800-243-7669

Instructions for :
You are registered for: Drug Test.
Your registration number is:
Registration Deadline:

Collector: Check Photo ID.
This Test is ONLY For:
*** ***
Corp ID Number for
is:
Please Put ID Number Into the ID field on the electronic CCF NOT the Social Security Number.

LabCorp Non Nida Info For Norton Medical:

Labcorp Registration
Number :
Registration Deadline:

Account #:
Location Code:
Panel Number:

Electronic CCF Profile:

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Desc:

Needs A

Please Use An Electronic Chain Of Custody Or Labcorp Non Federal CCF Form