Service request

Tell us which testing workflow you need.

Submitting this form starts the review. Dapsim confirms whether the request is collection-only or Dapsim-managed, then confirms timing, laboratory/MRO scope when applicable, and final fees before dispatch.

Submit the requestIdentify DOT/non-DOT, test reason, donor count, timing, and whether you already have a lab order/CCF.

Receive confirmationDapsim confirms availability, service model, arrival window, provider workflow, and final charges.

Collect and completeThe authorized collection is performed and routed through the confirmed reporting workflow.

For urgent post-accident or reasonable-suspicion needs, call 470-789-3045 after submitting. After-hours service is subject to availability.

Full name *

Company

Phone *

Email *

Service *

Program type *

Test reason *

Laboratory order / CCF status *

Number of donors *

Timing *

Preferred date *

Preferred time *

Service address *

City *

ZIP code *

Employer / DER contact

DER phone

Alcohol test also requested?

Suitable restroom available?

Site instructions and notes