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Cedar Rapids Iowa online Form 8857: What You Should Know

A copy of a medical report from the patient will be returned along with the form. The test requital form will not be used. Inpatient and Outpatient Drug Abuse Clinic Each drug abuse clinic must complete a questionnaire which includes the date of the drug abuse event. This information may allow you to request information about the patient when conducting a clinical exam. A completed drug abuse clinic questionnaire must be filed with your state health facility and submitted to the office of medical services to schedule an appointment for obtaining a testing order. A sample drug abuse questionnaire may be used. Please see a drug rehab program for details. If the clinic's office requires a full drug abuse form, submit it directly to the local state health facility. Online Testing Request Forms All requests for a drug test must be filled out with the following information: The name of the patient and a contact person who can be contacted if testing is required If the patient is an adult, include the date of the event The date and location of the event that is to be tested The specific substance and the reason(s) for the test The reason for testing The amount of your taxes to be tested each year Amount of your tax to be tested each year The fee(s) to be paid in lieu of testing You will be required to submit this information with your request for a drug test if using the state health facility's online testing order form. To complete your online ordering, just fill out the requested information from the Drug Abuse Clinic Request for Testing Forms page. The Drug Abuse Clinic Request for Testing Forms page is located on the form that you choose to complete online. If using an online form, please be sure to complete the drug abuse form and then complete the drug abuse clinic request form when you click on the Drug Abuse Forms link. Call the Local Health Facility To receive information about their programs and the testing process, all local health facilities are required by law to provide information about their drug abuse screening program. Drug Abuse Clinic Request Form An online form may be used to request a test, but you will need to contact the office in person for the exact testing protocol, payment, and appointment information. Drug Abuse Clinic Request Form — Electronic Format If you have an online drug abuse screening request form that is being used, you will need to make sure to complete the testing schedule from the Drug Abuse Clinic Request Form and send it directly to the local health facility. The Drug Abuse Clinic Request Form can be found on the forms section of this website.

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