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Employer Account Registration (Non-DOT)

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Employer Account Registration (Non-DOT)brijesh@vertical22.com2026-03-12T02:28:17-05:00
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Drug Test Panel Pricing

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1Start Page
2Contact Details
3Drug Testing Details
4Service Agreement
5Payment Authorization
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You can order this directly through our drugtestingshop.com website.
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CONTACT DETAILS

Please provide accurate details. We need this information for invoicing, account set up and other correspondence.
Main Contact Name*
Physical Address*
Mailing Address*
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UNDERSTANDING YOUR DRUG TESTING REQUIREMENTS

Please answer these questions to help us understand drug testing needs
Written Drug Free Workplace Policy*
Max. file size: 512 MB.
Do you want to order a drug test today?*
You can order a drug test online at this link. Use Courtesy Code: 10OFF to get $10 off on your order.
Would you like Random Testing?*
We will contact you about your random testing requirements. Program management fees will not be charged until we have discussed it with you.
Do you need 24/7 testing for random, post-accident or reasonable suspicion testing?*
Please send me information about other occupational health services:
Test all existing employees after initial 30 or 60 days of start of the Drug-Free Workplace program?*
Person(s) authorized to receive drug screen results:*
Full Name
Direct Phone
Email Address
 
Use the (+) sign to add more authorized recipients.

DRUG & ALCOHOL TESTING PROGRAM SERVICE AGREEMENT

Service Agreement outlining the Terms and Conditions between the Client and InOut Labs.
Service Provider: InOut Labs, 456 W. Frontage Rd. , Suite 103, Northfield, IL 60093
Main Contact Name*
Physical Address*
Mailing Address*
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Select Your Drug Test Panels (Select up to 3 tests)
Prices listed are examples. If you want something else, please tell us in the Comments box. Click here for other available panels. 
If you want something else, please tell us in the Comments box.
- Pricing is for "In-Network" collection sites. Out-of-network collections are $20 additional
- Use our Lab locator to find 1000s of collection sites across the nation
- Questions? Call us at 847-657-7900 or email us at info@inoutlabs.com
General Terms and Conditions*
Client Name*
Clear Signature

AUTOMATIC PAYMENT AUTHORIZATION

We require that a payment method be kept on file with us for security. You will, however, receive monthly invoices which you can pay with a check, online card payment, or ACH via GoCardless (preferred). You authorize us to charge your card for unpaid invoices if we need to. And if you prefer that we automatically charge it, please let us know.
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Billing Contact Name*
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Billing Contacts*
Full Name
Email
Phone
 
Use the (+) sign to add more billing contacts.
Billing Address*
I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify InOut Labs in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that InOut Labs may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.
- Your credit card will not be charged. It will be stored securely and charged only when you order a drug test
- Your card is completely secured with our payment processor, Stripe and our website is protected with SSL certificate
- If you have any questions feel free to call us at 847-657-7900 or email us at info@inoutlabs.com
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Payment Terms and Conditions*

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify InOut Labs in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that InOut Labs may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.  I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.

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