Priority Research

Priority Research Corporation:
Enter Client Code (if applicable):
*Organization Name:
*Street Address:
*City:
*State:
*Zip:
*Contact Name:
*Contact Email:
*Telephone:
Fax:
How long has the organization been established?
*Type of Organization:	(e.g. Church, School, Flower Shop)
*Purpose for Background Checks:
Tax ID Number:
*Billing Contact:
*Billing Contact Email:
Enter the number of users for the account:
Select if ordering drug screening. Select the type of drug screen (each type is the same cost): 5 Panel 10 Panel Select the clinic provider(s) you would like to use: LabCorp Quest Diagnostics Chain of Custody forms are required, which will be forwarded to you upon sign up. Please allow 1 week for the forms to arrive via mail. There is no setup cost.
Select if ordering credit history reports. Download the required FCRA forms by clicking here and fax them to (800) 319-5582. I have downloaded the appropriate files and will fax them to the number above. Further FCRA compliance documents are required, which will be forwarded to you upon sign up. A physicial inspection of your location is required by Federal Law. A one-time $75 fee will be charged to your credit card in order to provide credit reports.
Click "Next" to enter Users & Billing Information.