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X Date To be completed by Employer Signature of patient or parent/guardian of minor o 5 PANEL DOT DRUG SCREEN MODE Reason for Testing o 5 PANEL NON-DOT DRUG SCREEN o 9 PANEL DRUG SCREEN o SYNTHETIC MARIJUANA/BATH SALTS o 14 PANEL RAPID DRUG SCREEN o OPTIONAL CONFIRMATION OF POSITIVE RAPID DRUG SCREEN o COLLECT ONLY DRUG SCREEN o DOT PHYSICAL o WORK PHYSICAL OUR FORM CLIENT FORM o FIT FOR DUTY PHSYICAL o DOT BREATH ALCOHOL TEST BAT o NON-DOT BREATH ALCOHOL TEST BAT o PULMONARY FUNCTION TESTS...
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Clients applying for services offered by social welfare organizations.
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The Intake Form - OCC is a form used to collect information about a person or organization applying for the Office of the Comptroller of the Currency's programs or services.
Certain individuals or organizations may be required to file the Intake Form - OCC as part of the application process for OCC programs or services.
The Intake Form - OCC can typically be filled out online through the OCC's official website. Detailed instructions may be provided on the form itself.
The purpose of the Intake Form - OCC is to gather necessary information from applicants in order to process their requests and determine eligibility for OCC services or programs.
Applicants may be required to report personal or organizational information, financial details, and other relevant data on the Intake Form - OCC.
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