1
Required Package

The Surgical Technology department at Edgecombe Community College requires the following background check and drug test to be performed. You will receive an email from Viewpoint Screening within 24 hours (1 business day) after you finish placing your online order regarding your drug test. This email will contain the instructions to have your drug test performed.

Drug Test:10 Panel + MDMA + Oxy
Price:$45.00




 
 
I have read, understand and agree to the Viewpoint Screening Disclaimer and Refund Policy.
Applicant Information
Do not place an order on someone's behalf. This form must be filled out by the individual who requires Viewpoint Screening services.  
First Name*:  
Last Name*:
Middle Name:
Alias/Maiden Name 1:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Alias/Maiden Name 2:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Alias/Maiden Name 3:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Social Security Number*:
-
-

Please Note: If you have not been issued a valid U.S. SSN then enter all zeros (000-00-0000) instead.
Date of Birth*:
/
/
(mm/dd/yyyy)
Gender*: Male        Female
Phone Number*: (111-111-1111)
E-Mail Address*:

 IMPORTANT 

Your email address will be your user name to log in. Login names cannot be changed.

Please make sure you are entering your correct email address. You will be unable to log in or receive communications from Viewpoint Screening if your email address is not valid.

Please make sure you are entering your correct email address. You will be unable to log in or receive communications from Viewpoint Screening if your email address is not valid.
 
Type E-mail address.


Re-type E-mail address.

 If you already have an account: 

you are required to use the same email address to prevent separate logins.

Separate logins will contain separate results / medical documents, and cannot be combined.
 
Current Residential Address:
If applicable, your address will used to determine your drug test collection location.  
Address*:
City*:
State or U.S. Territory*:

For an international address, select "International" and select the foreign Country name below.
Country*:
Zip Code*:
ZIP Code Look Up Tool
Please Note: If you have an international address that does not require a Zip Code, please fill in "00000".

Please make sure you have provided correct information. Changes cannot be made once you have placed your order.
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