City, State, Zip Code
Are you currently a Siemens customer?
Are you a Current Siemens customer
Physician Office Lab
What is your current method of testing?
Onsite Drug Testing
Immediate (0-6 months)
12 + months
No Plans – seeking information only
I am interested in receiving more information on the following:
Automated Drug Testing
By checking this box, I understand/agree that the data captured today will be saved electronically, processed and used by Siemens only in the way and for the purpose described. I understand/agree that this information may be sent to Regional Siemens Healthcare organizations for follow up in the manner I have requested. I may withdraw consent at any time via email.