Reschedule Missed Appointment - Level 2 Background Screening Services

DUE TO THE CURRENT PUBLIC HEALTH CRISIS MASK REQUIRED FOR ENTRY!

NO ENTRY FOR CUSTOMERS WITH ANY OF THE FOLLOWING SYMPTOMS:

COUGH, SNEEZE, SORE THROAT, RUNNY NOSE, FEVER, ANY COLD/FLU TYPE SYMPTOMS

Please use this form to pay the $10 missed appointment fee. You will be sent to a page where you can pick a time and date that better fits your schedule. A $10 fee will apply to all missed appointments, so please make your appointment on time. We do not provide refunds for missed/no show screenings.

Name of Person that missed appointment*
Contact Phone #*
Level2 Livescan Screening Location*
- Level2 Jacksonville; 1626 Camden Avenue
- Level2 Riviera Beach; 4910 Dyer Blvd
- Level2 Stuart; 5534 S Kanner Highway
Level2 LiveScan Screening Cost includes required State of Florida Sales Tax
ORI Number*

Agency where your results are to be sent.
Hidden
How Many People Are You Paying For:*
Enter the number of screenings you are purchasing:
Screening Total Charge:
$0.00
Credit Card*
Card Details
Cardholder Name
Credit Card Billing Info*
ZIP / Postal Code
Send Receipt to This Email Address*
- By clicking this box I am requesting as the credit card holder to charge the credit card listed above the amounts indicated above.
Signature*

Customer Signature
CAPTCHA
After YOUR registration has been submitted, you will be allowed to set your appointment date, time and location of your choice, depending on availability
Comments
This field is for validation purposes and should be left unchanged.