Drug Screen Registration Instructions 21513057848210
User Manual: Pdf
Open the PDF directly: View PDF 
.
Page Count: 2
1.
2.
3.
4.
5.
6.
Fidelity Information Services, Inc. (10 yr) Drug Screen Registration Instructions
Full name: Jackson Samuel Daniel Sudharson
Request number: HA-120117-J54U9
Dear Jackson Samuel Daniel Sudharson:
HireRight is a third-party administrator that has been contracted by Fidelity Information Services, Inc. (10
yr) to arrange all the details of your drug screening. Please follow the instructions below to complete your
screening.
Your authorization number is . This registration 22923840 expires on December 11, 2017 02:59 PM
CST.
The following specimen collection site has been selected for your drug screen:
Quest Diagnostics-Layton PSC
4852 S 6th St, Milwaukee, WI 53221
(414) 483-4660
Show on map
Please take this page with you to the specimen collection site. When you arrive at the collection site,
please present this page and a government-issued photo ID.
We recommend that you call the collection site in advance for hours of operation and availability.
The expiration date/time of your registration may not align with the hours of operation for the collection
site. Also, some collection sites may require arrival one hour before closing time.
Please note that children will not be allowed into the testing area with you. If you have small children
who will be accompanying you to the testing facility, they will be required to remain in the waiting room
during your visit. Please arrange to have another adult with you to supervise any infants or children that
accompany you to the facility.
If you would prefer an alternate location, you may also locate a Quest specimen collection site by
completing the following steps:
Go to .http://www.questdiagnostics.com/hcp/psc/jsp/hcp_psc_index.jsp
In Section 1, enter your preferred street address or ZIP code.
In Section 2, make the following selections:
- Drug Testing
- Urine Drug Test
Click "Find".
If available, please select only facilities named Quest Diagnostics.
No additional registration steps are required; simply take this authorization form to the new
collection site prior to the expiration date and time.
COLLECTOR INSTRUCTIONS: QUEST APPROVED AUTHORIZATION FORM
Forensic Drug Testing Authorization Form
Order Expiration Date/Time: December 11, 2017 02:59 PM CST.
Authorization Barcode #: 22923840
Employer Information Medical Review Officer/Managed Service Provider
Fidelity Information Services, Inc. (10 yr)
customerservice@hireright.com NDI, A HIRERIGHT COMPANY
4600 PARK ROAD, SUITE 500
CHARLOTTE, NC 28209
Phone#: (800)272-3350
Fax#: (704)364-5961
Test Information
Donor Information Test Details
Name: Jackson Samuel Daniel Sudharson
ID: ***-**-9487 Reason for Test: Pre-employment
Account: 10273092
Service(s) to be Performed
Service Laboratory Laboratory Test
Urine Drug Test Quest Diagnostics 9 Panel as established for customer's account
Please contact HireRight Drug and Health Screening Customer Service by phone at (866) 521-6995,
option 1 or by email at if you have further questions regarding the OHSCustomerService@hireright.com
process.
Customer Service
Drug and Health Screening
HireRight, Inc.
Phone: (866) 521-6995, option 1
