Collection Sites Supplies Order Form

If you are a collector performing collections on DriverCheck clients and require supplies; fill out the form below. To submit your order, click ‘Place Order’ at the bottom of this page. An email order will be sent to DriverCheck.

If you need assistance, contact DriverCheck at
1 (800) 463-4310 Monday to Friday between 8am and 8pm EST, or email us.

Your Company Information

Collection Site Name

Contact Name

First and Last Name, Respectively

First Name

Last Name

Phone

Phone Number of the Site

(###)

###

####

Email Address

Address

Address of the Collection Site

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Alcohol Supplies

Mouthpieces (AlcoSensor IV Black Dot EBT)

Tamper evident tape (roll) 

Q.E.D. A150

Printer ribbon (Epson/AlcoSensor IV)

Non DOT Alcohol Forms English

DOT Alcohol Forms: English

DOT Alcohol Forms: French

Non DOT Alcohol Forms: French

POCT Supplies

Enter POCT Supplies

Quest 9 Panel Urine POCT kits

7 Panel Urine POCT Kits

8 Panel Urine POCT Kits

10 Panel Urine POCT kits

12 Panel Urine POCT Kits

Fentanyl Urine POCT Dip

Innovacon Urine Adulteration Test Strip

POCT Custody and Control Forms - English

POCT Custody and Control Forms - French

Lab Supplies

DOT Custody and Control Forms: English

DOT Custody and Control Forms: French

Non DOT Custody and Control Forms: English

Non DOT Custody and Control Forms: French

Split Drug Kits

Purolator Waybills

Need an item not listed? Please fill in below

For ordering supplies for your own purpose and not associated with testing on DriverCheck clients, please call or email: Anne Skipp directly. National Service Consultant. Tel 1-800-338-3998, anneskipp@drivercheck.ca.