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Background Check & Drug Screen Request

Use this form to request that Texas Rescue Med initiate your background check through Checkr and/or send you the information needed to complete your drug screen through Any Lab Test Now.

Please review the information below before submitting your request.

What This Form Is For

  • Request a background check through Checkr.
  • Request drug screen instructions for Any Lab Test Now.
  • Provide Texas Rescue Med with the information needed to begin the process.
  • Keep a clear record of your compliance request.

Important Information

  • Submitting this form does not mean you are cleared for skills, clinicals, or field experience.
  • You must monitor your email closely for next steps and instructions.
  • Your background check and drug screen must still be completed and reviewed.
  • Please make sure the information you submit is accurate so there are no delays in processing.

What Happens Next

  1. Submit the request form below.
  2. Texas Rescue Med will review your request.
  3. If requested, your background check will be initiated through Checkr.
  4. If requested, you will receive the information needed to complete your drug screen through Any Lab Test Now.
  5. Once completed, results will be reviewed by Texas Rescue Med.

Submit Your Request

Complete the form below to request your background check and/or drug screen information. Please allow 2–3 business days for processing.

    Background Check & Drug Screen Request

    Please complete this form if you need Texas Rescue Med to initiate your background check through Checkr and send you the information needed to complete your drug screen through Any Lab Test Now.

    Important: Submission of this form does not mean you are cleared for skills, clinicals, or field experience. Your background check and drug screen must still be completed and reviewed.

    Student Information








    Request Type


    Student Acknowledgment

    Additional Notes