Request Quotation | Testing Services | Trimega Laboratories - UK Hair Drug Testing & Hair Alcohol Testing

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Please complete all areas* of this request form to ensure that we can provide you with a detailed quotation and note the permanent fields that are required (red boxes). Upon receipt of your form, your request will be dealt with immediately and a quotation will be sent to the details you provide below (via fax). A copy of this form will be sent to the email address provided for your reference.

* Please note that the more information you can supply us with, the more accurate our quotation will be.

Donor Details

Donor Name:*

Salutation:*

Contact Number:

Date of Birth:*

Court Filing Date:

General Information

Delivery of Results & Invoice Information:

Name*

Organisation*

Address*

Post Code*

Tel No*

Fax No*

Email Address*

Reference*

Split invoicing?

Yes

Split invoicing incurs a charge of £20.00 + VAT per party. Please provide details upon completion of this form and send in separate documentation to info@trimegalabs.com. We require for all parties: name of firm and fee earner, relevant reference number, address, telephone and fax numbers. We will not be able to split invoices without this information.

Updates will be generated by email to the address you have supplied above to notify you on the progress of your test. Would you like to receive these emails?

Yes

Testing kit to be dispatched to/collection location:

Same as above: New details:

Name

Organisation

Address

Postal Code

Tel No

Fax No

Opposing Solicitor Details:

Name

Organisation

Address

Postal Code

Tel No

Fax No

Reference

Alcohol Abuse Testing (Complete if applicable)

Alcohol Questions (Please complete):

Has donor had history of excessive alcohol consumption? Yes No Other Reason

Abstinent since (indicate date if applicable)

Test(s) Required (Tick as appropriate)

Blood Tests:

Carbohydrate Deficient Transferrin (CDT)
Liver Function Test (LFT)

Hair Alcohol Testing:

EtG (Bronze)
We strongly recommend that EtG tests are combined with FAEE to increase the accuracy of interpretation. Please note that there is a % of "washout" effect in EtG tests, which could result in a false negative result. This does not apply to FAEE tests.
FAEE (Silver)
Winner of the UK Best Use of Technology Award 2008.
Combined EtG & FAEE (Gold)

Combined Package:

The Complete Package
This package combines FAEE and EtG (hair), CDT and LFT (blood) tests; including expert witness statement and sample collection.

Expert Witness Statement (Tick as appropriate)

Expert Witness Statement - Trimega Laboratories include within the testing charges a Certificate of Analysis and a summary with an extended report. We can provide an Expert Witness Statement for court purposes as and when it is required that includes the clarification of the diagnostic findings. This is charged at an additional cost and is available for both Drug and Alcohol tests.

Drug
Hair Alcohol
Blood Alcohol
Hair & Blood Alcohol

Trimega Nurse Sample Collection (Tick as appropriate)

Sample Collection - Trimega Laboratories provide a network of nurses who may attend your office or your client's home to collect the sample. The cost of collection is charged as an extra cost if you have not requested for The Complete Package. Please indicate YES or NO if you wish to have your client's samples collected by one of our nurses.

YesNo

Please indicate the initial point of contact when arranging the sample collection:

Solicitor / Social Worker
Other (e.g., donor / donor’s guardian / opposing firm)

Full name of contact indicated above
Contact telephone no.
Preferred appointment dates (if any)

(please note that any appointment dates indicated above are not guaranteed and are subject to nurse availability)

Your Details

If your details are different from the details provided in the "Delivery of Results & Invoice Information" section, please provide us with your full name and contact information.

Your Name
Contact Telephone No.
Email

The highlighted boxes above may still need the correct information.

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