Med Compliance
217-549-2216
SIGN UP NOW

Fill out the FORM for immediate entry into a
Random Drug & Alcohol Program

Your list of participants will be added to the
consortium of like employees.

You will receive the participation material in
the mail as soon as payment is received.

Materials include Drug & Alcohol Policy,
regulations, required forms, a storage
binder for random selection notifications,
D.O.T. Supervisory Training,
Unlimited Support


Give us a call today for assistance.
217-549-2216

Our mission is to
provide an
economical
advantage to those
striving for a
drug-free workplace.

Our small company
proves to be able to
handle the largest
of companies at the
smallest of fees,
while maintaining a
high level of service
using state of the
art software and
facilities.
Choose the type of program
needed for your company:
Enter the Name & Address
of your company
Include
phone & fax numbers:
Enter the List of Participants
that will be included in the
Drug and Alcohol Program
Contact Person:
Enter information for the
Contact Person.  
This is the person scheduling
tests and receiving results.
Phone:
Email:
Payment:
You can enter credit card information for immediate participation
or we will be glad to send an invoice.

You will receive detailed invoice information and an approval request
BEFORE the credit card is processed.   
Participation material will be mailed when payment is received.
Credit Card Number:
Expiration Date:
Zip code of card holder,
if different than zip above: