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Independent Request

Independent Request

Please review and complete the form below for independent requests.

Once this information has been received, you will be contacted to process payment and book the appointment. 

We can only begin making arrangements for your request upon the return of this form. Please note, all independent testing must be booked within the collection site’s regular business hours. Do not arrive at the collection facility until instructed to do so by a CannAmm agent once the appointment date and time have been confirmed. In addition, payment is required at the time of booking by credit card. We do accept pre-paid credit cards.


Independent Request Form

Independent Request Form For Drug and Alcohol Testing Services

"*" indicates required fields

Contact Information

The individual we contact to process payment and book the appointment
Name*







Donor Information

Individual being tested.
Name*








MM slash DD slash YYYY

Please note that it may take up to 48 hours to schedule testing and requested appointment times are not guaranteed. All tests are booked on a first-come first served basis.

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Estimated Timelines

Lab testing – Samples that screen Negative typically result within 24 hours once the sample is received at the laboratory. Samples requiring confirmation testing typically result within 72 hours.’

Express testing – This is a screening tool only. If the sample is inconclusive and requires confirmation testing, results may take up to 5 business days. Otherwise, results are typically reported out the same day.

Please note – courier delays can be a factor in delivery; this is beyond our control and typically takes 1-3 business days depending on the city of collection.

Please see information below on available test types and compliance categories.

Note

IOL panels are only to be selected when testing specifically for KEARL LAKE sites.

CRLA-BC panels are only to be selected when testing specifically for CRLA-BC.

Excluding Taxes
All Sales Are Final*

Consent

I AGREE that I am responsible for understanding, the associated protocols as stated in this document and advising the individual scheduled for testing ( if applicable). The information
enclosed is accurate to the best of my knowledge.
Name*








MM slash DD slash YYYY

Additional Information

** Test type selections include the Canadian Model V6.1 drugs and respective cut-off levels below. 

Canadian Model V6.1 Requirements

 

Panel Drug Test

EXPRESS URINE: 5 Panel (Semi-Syn OPI)

(Urine only)

5 Panel (Semi-Syn OPI)

(Urine and Oral Fluid)

5 Panel (Semi-Syn OPI) + Fentanyl

(Urine only)

 

10 Panel (Semi-Syn OPI)

(Urine only)

12 Panel (Semi-Syn OPI)

(Urine and Oral Fluid)

12 Panel (Semi-Syn OPI) + Fentanyl

(Urine only)

 

Illicit

Substances

Tested For

Marijuana (THC)
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Cocaine
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Amphetamine/
Methamphetamine
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MDMA (ecstasy)
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Opiates
(Codeine/Morphine)
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6-Acetylmorphine (Heroin)
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Phencyclidine (PCP)
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Hydrocodone/
Hydromorphone
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Oxycodone
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Oxymorphone
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Benzodiazepines      
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Barbiturates      
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Methadone      
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Propoxyphene      
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Methaqualone      
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Fentanyl    
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Compliance Category

Independent Test Type

Construction Owners Association of Alberta Canadian Model V6.1 (COAA V6.1) Compliant URINE: 5 Panel (Semi-Syn OPI) & Breath
ORAL FLUID: 5 Panel (Semi-Syn OPI)  & Breath 
CLRA-BC Compliant- BC Policy ORAL FLUID: CLRA-BC Panel (Oral Fluid) w/ Breath Alcohol 
COAA V6.1 Compliant with Additional Drugs  ORAL FLUID: 12 Panel (Semi-Syn OPI) & Breath
URINE: 5 Panel (Semi-Syn OPI) + Fentanyl & Breath
URINE: 10 Panel (Semi-Syn OPI) & Breath
URINE: 12 Panel (Semi-Syn OPI) & Breath 
URINE: 12 Panel (Semi-Syn OPI) + Fentanyl & Breath 
Imperial Oil Compliant  URINE: 10 PANEL (IOL) & Breath
Other Options (NOT COMPLIANT TO BOTH COAA V6.1 & BC POLICY) EXPRESS URINE: 5 Panel (Semi-Syn OPI) & Breath
EXPRESS URINE: 12 Panel (Semi-Syn OPI) & Breath
  • Urine Laboratory Testing: Gold standard and leading practice within the testing industry. Highest assurance of accurate results. The urine sample is sent to a SAMHSA-certified laboratory for Testing.
  • Breath / Saliva Alcohol Testing: Breath Alcohol testing is most common method used to detect alcohol. If a screening result displays a blood alcohol level at or above a level of 0.020, a breath alcohol confirmation test is required using a evidential breath- testing device (EBT). Saliva alcohol can only be used as a screening device. If the screening result detects alcohol, a confirmation test is required using a evidential breath-testing device (EBT).

Test Method Not Recognized Under the Canadian Model V6.1

  • Express Urine Testing: Prompt results, but not as accurate as a laboratory based test. Performed with a Point of Collection Testing device (POCT) at the collection site. If the sample tests negative, this is the final result. Inconclusive samples are forwarded to a SAMHSA-certified laboratory for confirmation testing.

*Note: currently there is no instant oral fluid device with FDA approval that also tests to the approved cut-off levels.

Receiving Results

  • Only the individual who is tested can access results or authorize a release of the results to another individual.
  • This is done by filling out a Request for Release Form at the collection site, or they may choose to print a clearance online at www.cannamm.com.
  • If printing a clearance online, the following steps will need to be completed:
    • From the CannAmm home page, select ‘Request Clearance Letter’
    • Enter your specimen ID number (located on the top of your copy of the chain of custody form provided by the collector)
    • Enter your surname (last name)
    • This will populate a PDF of the clearance letter that can be emailed, saved or printed.

Important Information For Appointment

  • Bring government-issued photo identification to the appointment.
  • Be prepared to provide the required sample (urine, breath, or saliva) at the time of the appointment.
  • The collection process for urine sample may take up to 3 hours to complete.
  • Children will not be allowed at the collection site unless supervised by someone other than yourself or site staff.
  • For additional information, please see our page: Preparing for Your Appointment
  • If you need to reschedule, or cancel, please advise CannAmm as soon as possible by calling 1.800.440.0023 option 4, or by emailing [email protected] (at least an hour’s notice) to avoid possible charges.