Employer Inquiry

Tell us about your business and what you need. We will contact you to talk it through.

Submitting a request does not book an appointment. Your appointment is not confirmed until Vein GPS contacts you.

Please do not enter sensitive health information.

Do not include medical records, lab results, Social Security numbers, drug-test results, diagnoses, or employee names or personal details in this form. We will discuss anything further by phone.

Company name

Your name

Your role or title

Phone number

Best way to reach you

Work location (city and ZIP)

We only need city and ZIP now. We will confirm the full address when we contact you.

Service needed

Type of collection

About how many employees need collections?

Preferred dates or timing

Anything else we should know?

Keep it general. Do not include employee names or results.

I understand this is a request only. My appointment is not confirmed until Vein GPS contacts me.

Prefer to talk? Call 252-375-4591 or email [email protected].