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Mission Request

 

Unit Request for Drug Testing Supplies
Submit request NLT 2 weeks before testing date

Please use the TAB key to go to the next field. 
If you press the enter key... it will submit the form
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Unit: 

Address: 
City:  State:  Zip: 

UIC/PRN: 

Date: 

UPL Name/Rank

Phone: 

Email Address

Commander Name/Rank: 

Commander Phone (area code): 

Commander Email: 

Unit Strength

Item

Quantity

Specimen Bottle
Collection Cup
Gloves
Absorbent Packs
Water Proof Bags
Specimen box w/divider*
  *Only order if you have empty bottles at Unit.

Testing Date: 

       

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