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8334596687 (WOOTS)|service@woots.ca

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pa 2aman@woots.ca2026-06-14T21:09:16+00:00

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Service Request

Please note if you don’t get reasonable reply in 15 -30 minutes please call +1 4164640620

only authorized personnel can request for the service other wise payment must be made prior to the service

Employer / Company Info.

COMPANY NAME *

Contact/DER Name *

First

Last

Phone with extension no. *

Email *

Driver/ Employee details

Driver/Employee Name *

First

Last

Location of the Driver/Employee *

Address Line 1

City

State / Province / Region

Smart Phone Number of Driver/Employee

Date of Test/Time *

Date

Time

Reason for the test *

Return to duty (Direct Observation Required)
Follow-Up (Direct Observation Required)
Post accident
pre-employment
random
resonable /cause

Mandate *

DOT
NON- DOT

Type of test *

Drugs only
Alcohol only
Both Drug and alcohol

Panel

5 panel dot urine
5 panel Non dot
SWAB/Silva/Breath

Panel

5 panel dot urine
5 panel Non dot
SWAB/Silva/Breath

Service Type

On site or In a clinic
Mobile Collection

Message

Signature *

Upload proof of payment if applicable

Click or drag a file to this area to upload.

Contact Info

service@woots.ca
8334596687 (WOOTS)
416 464 0620 (9 am to 5 pm est ont. Time)
www.woots.ca

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Address

11-7003 Steeles Ave W,
Etobicoke, ON M9W 0A2

6909W Ray Rd. #15-122
Chandler A.Z. 85226

Site coming up in North east Brampton

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