For Existing Customers Only

Please fill out the form below to request a new order of PharmChek® products. Your sales representative will immediately receive your request and process your order.

Your Information

Order Details

Please note that each PharmChek Sweat Patch Kit contains the following:
PharmChek Sweat Patches, CoC forms, pre-addressed lab mailers, alcohol wipes, specimen bags, transport bags, and single-use tweezers.

Chain of Custody Forms Are Included in the Kit

Shipping Information

Type of Address *

Please indicate whether the address provided above is a business or residence.

Additional Comments (optional)