Sign up for UNC Street Drug Analysis Lab
Thanks for your interest in the UNC Street Drug Analysis Lab! We need to collect some information to make sure we serve you best. Please answer as thoroughly as possible to expedite onboarding.
Program Name
Your name
Name of person responsible for drug checking at your org
What kind of program are you with?
Harm reduction program
Drug user union
Health department
EMT/PORT
Clinic or hospital
Medical examiner
Researcher
Individual or no program
Other
We cannot provide services to individuals
Are you an FTIR-based drug checking program?
Yes
No
If you are already doing or in the process of getting set up for machine-based drug checking.
Your role at organization
Staff
Volunteer
Student
Participant
Other
Email address
Phone
Sometimes it's easier to just talk but it is also needed for kit shipment
Street address
Place to mail kits. No PO Boxes.
State
Zip
County
County of your program
How did you hear about us?
Please let us know if you were referred by another program
How will you use the kits?
Tell us about your program and how you intended to use drug checking. The main aspect of our program is that samples are given voluntarily from participants and results cannot be used to penalize participants or deny services.
Do you have funding for mail-based drug checking?
Yes we have funding now
We are applying for funding
No funding
Helps us match you to the right pricing. We offer 5 free startup kits so we will need this information for invoicing purposes. We offer pay-as-you-go, or pre-paid.
Affilation
Are you funded by another program who uses our services or underneath a larger entity? (i.e health dept., university, DHHS, larger cbo, etc.) If so, who?
Uploading files
