ADVANCED BUSINESS INTERVENTION / National Medical Services, Inc.

Referrals --

Home
Our Credentials
Substance Abuse Testing
Wellness Testing
Staff
Testimonials
Referrals
Contact Us
Federal Supervisors Training Course
DOT Policy and Compliance

If you are interested in our services, please take a moment to complete the form below and send it to us.  We will respond quickly to your needs and your request for information.

Many clients are referred to us by another satisfied client. Recommendations have allowed us to build a business family unique in terms of character, responsibility, and awareness.

So if you have friends or acquaintances who would be interested in our services, just use the form below to let us know who they are. We're sure they would appreciate your recommendation and so would we.


NAME OF COMPANY OR AGENCY _________________________________________________________

ADDRESS ______________________________________________________________________________

CONTACT NAME ________________________________________________________________________

CONTACT PHONE NUMBER ______________________________________________________________

CONTACT E-MAIL ADDRESS _____________________________________________________________

TYPE OF BUSINESS _____________________________________________________________________

NUMBER OF EMPLOYEES ________________________________________________________________

DO YOU PRESENTLY DO SUBSTANCE ABUSE TESTING? _____________________________________

DO YOU HAVE SAFETY SENSITIVE OR COMMERCIAL DRIVER EMPLOYEES?____________________

ARE YOU INTERESTED IN RANDOM TESTING? ________  PRE-EMPLOYMENT TESTING? _________ 

POST ACCIDENT TESTING? ___________ FOR-CAUSE TESTING? _____________

IS THERE OTHER INFORMATION THAT WE SHOULD KNOW ABOUT YOUR COMPANY?

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________ 

Please print this form and fax it to us at
603-719-7155

*****

Advanced Business Intervention / National Medical Services, Inc. *Phone: (877) 875-9530 / Fax: (603) 719-7155

This site  The Web

Web site hosting by Web.com