Ready For My Drug Screen

If you are ready to arrange your drug screen, please complete the form below. You will then be directed to the Drug Screen Payment page for the C$75 Administrative Fee.

Your Name

Your Email Address

Your Phone Number

I understand that this Drug Screening procedure is a private transaction between me and the Drug Screening center.

I understand that this procedure will payable directly to the Drug Screening center at the time of my scan.

I understand the VIP Docs Inc. is performing an administrative not a medical service and that the cost is $75 Canadian Funds payable online by credit card at the time I complete this form.

I understand that there is no assurance or guarantee that O.H.I.P. or any other agency or insurance company will reimburse me for the cost of this procedure.

I understand that it is my responsibility to keep the agreed appointment for the screening and that I am responsible for the cost of the appointment if I do not keep the appointment for any reason.

Questions or comments?

www.mriscan-petscan-catscan.com

Your continued use of this website affirms your agreement with the Terms and Conditions found in the Legal section of the website.

Last updated July 21, 2008