Fast, Accurate & Affordable Lab Testing in Georgia

Business Account Set Up

Credit Card Authorization

Your credit card will be charged for invoices at the beginning of each month for outstanding invoices from the previous month. You will receive your paid invoices via email (or mail) which will correspond to each credit card charge.

If you prefer, you may email the completed PDF to or fax to 678-578-6384.

Company Information
Company Name*
Year Founded*
Contact Name*
Contact Phone*
Contact Email*
Total Number of Employees Subject to Testing*
Estimated Drug Screens Per Month*
Credit Card Information
Name on Card*
Credit Card Type*
Card Number*
Exp. Date*
CVV Code*
Billing Address*
We would like our invoices:*
Email to Receive Invoices*
Mail Invoices To*
Test Results
We would like the results of our employee tests:*
Email Results To:*
Fax Results To:*
By submitting this form, you authorize Any Lab Test Now to charge your credit card for outstanding invoices according to our payment terms.
Applicant Name*
Job Title*