Nao Medical — employer exam request planning checklist
Preparation aid only. This is not a clinical order, employer authorization,
or DOT custody-and-control form. Do not add employee medical information.

[ ] Employer and ordering contact:
[ ] Requested service and current form:
[ ] Applicable program (including DOT/non-DOT where relevant):
[ ] Required panel / test method, when applicable:
[ ] Authorization or account reference required by the program:
[ ] Clinic capability and appointment instructions confirmed:
[ ] Identification, forms and clinic preparation instructions confirmed:
[ ] Completion deadline and reporting deadline:
[ ] Payment or employer billing arrangement:
[ ] Authorized reporting recipient and channel:
[ ] Contact for missing information or a missed visit:

Employer program consultation: https://calendly.com/farooqu-naomedical
Updated September 27, 2026.