Online Booking Form What kind of testing do you need? What kind of testing do you need? What kind of testing do you need? Rapid Covid-19 Antigen Screening Occupational Health Testing Drug and Alcohol Testing covid-19 Individuals must be asymptomatic. Occupational Health Testing Occupational Health Testing Occupational Health TestingPlease select from the list of occupational health tests below. If you don't require any occupational health testing, please go to the next step. Occupational Health Audiogram Blood Test for Heavy Metals Chest X-Ray Confined Space Entry Assessment Health Assessment Health Assessment Completion Health Assessment w/ Physical Fitness Screening Health Assessment w/ Physical Fitness Screening Completion Hearing Protection Fit Testing Laboratory Testing (Other) Pulmonary Function Test Quantitative Mask Fit Test (Includes Fitness for Wear Respirator Evaluation) Stand Alone Fitness to Wear Respirator Evaluation Silica Exposure Test (Pulmonary Function, Chest X-Ray, Silica Screen) Stand Alone Lifting Assessment Stand Alone Vision Screening Please enter your position/PDA Enter Test specific and a Shift OHS Inc. representative will reach out to discuss prior to scheduling 1 Enter the Manufacturer and Model Number of Required Mask Model Number 1 Enter the Manufacturer and Model Number of Required Mask Model Number + Additional Mask Drug and Alcohol Testing Drug and Alcohol Testing Drug and Alcohol TestingPlease select from the list of drug and alcohol tests below. If you don't require any drug or alcohol testing, please go to the next step. Alcohol US Breath Alcohol Test Breath Alcohol Test Drug (Oral Fluid) 7 Panel Lab Based Oral Fluid 10 Panel Instant Oral Fluid 8 Panel Lab Based Oral Fluid 10 Panel Lab Based Oral Fluid 12 Panel Lab Based Oral Fluid Add Fentanyl Lab Based Oral Fluid Drug (Urine) DOT 10 Panel Lab Based Urine 10 Panel Instant Urine 10 Panel Lab Based Urine 12 Panel Instant Urine 12 Panel Lab Based Urine 7 Panel Instant Urine 7 Panel Lab Based Urine 8 Panel Instant Urine 8 Panel Lab Based Urine 14 Panel Instant Urine 9 Panel Instant (IOL) Urine 14 Panel Lab Based Urine 9 Panel Lab Based (IOL) Urine Add Fentanyl Instant Urine Add Fentanyl Lab Based Urine Specialized Lab Based Urine Reason for Testing Reason for Testing Reason for Testing Test reason Baseline Follow-Up Other Periodic / Health Surveillance Post-Incident Pre-Access / Site Access Pre-Employment Private Pay Random Reasonable Cause Return to Duty Pre Access SiteIf you’ve selected Pre-Employment, Pre Access, Post-Incident or Reasonable Cause AND the individual is working on a Third-Party site, please provide the Third-Party Company Name / Work Site here. General Information General Information Contact Information* Requested location, date, & time are not guaranteed but we will do our best to accommodate each request Participants Participants First & Last Name * Division (if applicable) Phone Number Email Location Preferred Date/Time of Testing * Preferred Date of Testing * Preferred Time of Testing AMPMAnytime Preferred Location of Testing (City / Province) * City * Province * Please provide additional information about participant locations or times here. 1 First Name & Last Name Division (if applicable) Phone Number Email Preferred Date/Time of Testing Preferred Date of Testing Preferred Time of Testing AMPMAnytime Preferred Location of Testing (City / Province) City Province Please provide additional information about participant locations or times here. + Add another participant Are you booking on behalf of someone else? * Yes No Booker Contact Information Booker Contact Information Booker Contact Information Booker First & Last Name Company Name (If applicable) Phone number * Email * Would you like us to send an email confirmation to the participants once the appointment has been scheduled? Yes No Additional Information Additional Information Additional Information Enter PO# (if applicable) Please provide any additional details (if applicable) Cancellation Policy: Cancellation Policy: Cancellation Policy Cancellation Policy *Please contact us at (403)343-6869 or [email protected] as soon as possible if you need to cancel or re-schedule your appointment. Appointments that are cancelled / rescheduled within 24 business hours of the scheduled appointment time may be subject to a No Show / Late Cancellation Fee I have read and agree to the cancellation policy above. Message Before submitting your booking request, please review your selections to ensure everything is correct. Validate Email Back Next