DRUG TESTING AUTHORIZATION FORM

DONOR MUST BRING THIS FORM AND PHOTO ID

Company: BRYCON CORPORATION

Employee:

Expiration 
(optional): CRL RAPID: OES.FFP1.2021

Employer Signature: Phone: 480 855 3379

REASON FOR TEST:

 Pre-Employment  Random
 Post-Accident  Reasonable Suspicion/For Cause
 Return to Duty (observed)  Other______________________________

TEST TO BE PERFORMED:
 12-Panel Instant - CRL OP48  Non-DOT Breath Alcohol

ALL LOCATIONS ARE WALK-IN ONLY - NO APPOINTMENT REQUIRED

AZC Drug Testing Locations Phone: Hours:
NEW 333 West Thomas Road, Suite 101 M-F 8:00AM-5:00PM
PHOENIX Location
602-242-4125
Phoenix, AZ 85013 SAT. 8AM-NOON
3150 N. Alma School Rd., Ste.7 M-F 8:00AM-5:00PM
CHANDLER 480-820-2298
Chandler, AZ 85224 SAT. 8AM-NOON
501 W Van Buren St, Ste. L M-F 8:00AM-5:00PM
AVONDALE 623-925-2388
Avondale, AZ 85323 SAT. 8AM-NOON
13660 N. 94th Dr., Ste. A-4
PEORIA 623-972-2000 M-F 8:00AM-5:00PM
Peoria, AZ 85381
1037 S. Alvernon Way, Ste. 150
TUCSON 520-745-1029 M-F-8:00AM-4:00PM
Tucson, AZ 85711
3965 E. Foothills Dr., Ste I
SIERRA VISTA 520-685-8828 M-F 8:00AM-4:00PM
Sierra Vista, AZ 85635

** Test results are only released to the company’s designated employee representative (DER). **

©AZCDT VER AUG2023