IQM: BUSINESS INVESTIGATIONS
PURCHASE ORDER AND INVOICE

To Use Specialized Alternative Services
Polygraph and Drug Abuse Screens

 669 Airport Freeway
Hurst, Texas 76053
Phone: (817) 282-3377
Fax: (817) 282-8833
Email: iqm@crime-free.com

IQM Business Investigations Alternative Services Work Order

Client's Authorization Signature and Title or PIN Number

First__________________ Initial____ Last__________________ Title_________________

Division/Unit Organization Name
Mail Address City State Zip
Phone Ext Fax Email

Investigative Description and Case Requirements

Subject for Examination
Last Name First Name  Full Middle Name
Date of Birth M D Y Social Security Number - -

Notes
Item Case or Element Description Order Special instructions Quantity
7-3320 Special Purpose Interview
7-3310 Polygraph Examination
7-3500 Drug Abuse Screen-NIDA
7-3600 NIDA Screen-Commercial


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