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Please complete the samples request form below and we will be in touch promptly with confirmation of your complimentary package and tracking. Thank you for your interest in our QuikTox™ line.

Want to speak to us today? Please call John, our Chief Revenue Officer at 858-828-6880

SalivaSplit™ Sample Request Form

First name*

Last name*

Company name*

Title*

Email*

Phone*

Please indicate your best SHIP-TO address

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

A few questions so we get to know you better:

What type of organization are you?*

Are you currently using oral fluid testing?*

Yes

Which specimen types do you currently use? (select all that apply)*

Urine

Oral Fluid

Hair

Breath Alcohol

Other

Approximately how many oral fluid tests could your organization use annually?*

What oral fluid product are you currently using?

How often do you require laboratory confirmation testing?*

What interests you most about SalivaSplit™? (check all that apply)*

Rapid Results

Split Specimen Collection

Laboratory Confirmation Capability

Easily Observed Collections

Ease of Use

Cost Savings

THC Recovery

Are you evaluating new oral fluid testing solutions within the next 30-60 days?*

Any additional comments?

National Screening Corp.

Innovative Testing Solutions Built for Compliance & Defensibility.

Reach out to us:

Sales: sales@nationalscreeningcorp.com

Billing: billing@nationalscreeningcorp.com

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National Screening Corp. | 6650 Flanders Drive, Suite H, San Diego, CA 92121

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