Refer a Client

Refer a Client

Refer a Client 2016-12-21T20:05:15+00:00
Please specify below
Client/Offender/Defendant Information Section
Referring Agency/Court/Department Information Section
Order Information Section

Standard curfew will be set to: 10pm-7am daily. Please notate any other schedule permitted below.

Standard testing schedule will be 7am fixed, 12pm noon fixed, 5pm-8pm random, 10pm fixed. Please modify testing schedule as required below.

Standard testing schedule will be 7am, 12pm noon, 5pm, 10pm. No random testing schedules. Client will be given a schedule of test times. Please modify testing schedule as required below.

Standard curfew of 10pm-7am daily. Please notate any exclusion zone addresses, and radius for each to be included. Please notate any other schedule permitted below.

Standard curfew will be set to: 10pm-7am daily. Please notate any other schedule permitted below.

Please notate any vehicle information available below.

This is a standard 12-panel test. Please notate whether tests are to be fixed or random and the number of tests to be performed monthly below.

Please notate standard 5-panel, or expanded opiate specific testing below.

Once submitted, please print the resulting order sent to your email and provide to the client/offender/defendant. Remind the client that they must call us immediately in order to set their appointment time. We will notify you if the client/offender/defendant has not contacted us within two-business days.