Ongoing alcohol monitoring

The Breath Test is an easy-to-use and convenient device that can help to monitor alcohol abstinence over a set period of time.

Get an online quote

Step 1 of 8

Your request will be processed immediately upon receipt. Quotations will be issued to all of the parties detailed on the form as instructed. Please call us on 029 2048 4141 for assistance with completing the form.

How did you hear about us?(Required)

What type of case is the testing for?(Required)

1. Participant details

Participant name(Required)

Sex at birth(Required)

Date of birth(Required)

MM slash DD slash YYYY

2. Abstinence Test – Please specify the time period of testing:

DrugPatch testing period:

10 days (one patch)

30 days

60 days

90 days

Breath Test testing period (For breath test packages, there is a minimum charge of 30 days).

30 days

60 days

90 days

3. Instructing Party Details – Please indicate who is instructing the testing:

Contact name:(Required)

Organisation:(Required)

Position:(Required)

Case ref:(Required)

Address:(Required)

Client's name:(Required)

Telephone(Required)

Email(Required)

Funded:(Required)

Legal aid

Local authority

Privately (Payment must be in advance)

If local authority: P.O Number:

Legal or social team:

Account ref:

4. Split Invoicing – If needed, please detail all additional parties who are liable for the cost of the testing:

If the cost is to be shared between a number of parties we will send a quotation to each for their share and invoice each for their share after the test results are issued. Each party will be required to authorise their quotation before the sample can be collected. In accordance with the Legal Aid Agency there is no charge for split invoicing.

Additional party no. 1 (if needed):

Contact name:

Position:

Organisation:

Address:

Client's name:

Tel:

Email:

Account ref:

Funded:

Legal aid

Local authority

Privately

Additional party no. 2 (if needed):

Contact Name:

Position:

Organisation:

Address:

Client's name:

Phone

Account ref:

Funded:

Legal aid

Local authority

Privately

Additional party no. 3 (if needed):

Contact name:

Position:

Organisation:

Address:

Client’s Name:

Phone

Account ref:

Funded:

Legal aid

Local authority

Privately

5. Result Details – Please include details of who will be receiving the results

Results will automatically go to the instructing party named in section 3 unless stated otherwise. To be completed by exception only by an additional result recipient (as applicable). Please note that the results will be issued to the instructing party in section 3 or any named additional recipient in this section. We will only discuss the results or the progress of the analysis with those receiving the results. The results will be issued as a one page report only.

Court date:(Required)

MM slash DD slash YYYY

Filing date:(Required)

MM slash DD slash YYYY

Additional result recipient(Required)

Yes

Contact name:

Position:

Organisation:

Address:

Phone

6. DrugPatch fitting – DrugPatch fitting will take place within a professional facility

Please note that a witness (i.e. a solicitor or social worker) must be present at all appointments. You will be contacted by Lextox to confirm availability for all necessary appointments.

6.1. Fitting Details:

MM slash DD slash YYYY

Preferred fitting dates (option 1)

Preferred fitting dates (option 2)

MM slash DD slash YYYY

Preferred fitting dates (option 2)

Witness name:

Witness position:

Witness contact number:

Address of fitting location:

7. Breath test set up: This will be undertaken by a Lextox Sample Collector only

You will be contacted by Lextox to confirm availability for all necessary appointments.

7.1. Where would you like the set up to take place?

Participants’ home

Office/Facility

7.2. Set up details (preferred set up dates):

MM slash DD slash YYYY

Option 1

Option 2

MM slash DD slash YYYY

Option 2

Witness name:

Witness position:

Witness contact number:

Address of set up location:

Download a quote form

Download our PDF quote form here

and email it to [email protected]

Get an online quote

Download a quote form

Get an online quote

Step 1 of 8

How did you hear about us?(Required)

What type of case is the testing for?(Required)

1. Participant details

Participant name(Required)

Sex at birth(Required)

Date of birth(Required)

MM slash DD slash YYYY

2. Abstinence Test – Please specify the time period of testing:

DrugPatch testing period:

10 days (one patch)

30 days

60 days

90 days

Breath Test testing period (For breath test packages, there is a minimum charge of 30 days).

30 days

60 days

90 days

3. Instructing Party Details – Please indicate who is instructing the testing:

Contact name:(Required)

Organisation:(Required)

Position:(Required)

Case ref:(Required)

Address:(Required)

Client's name:(Required)

Telephone(Required)

Email(Required)

Funded:(Required)

Legal aid

Local authority

Privately (Payment must be in advance)

If local authority: P.O Number:

Legal or social team:

Account ref:

4. Split Invoicing – If needed, please detail all additional parties who are liable for the cost of the testing:

Additional party no. 1 (if needed):

Contact name:

Position:

Organisation:

Address:

Client's name:

Tel:

Email:

Account ref:

Funded:

Legal aid

Local authority

Privately

Additional party no. 2 (if needed):

Contact Name:

Position:

Organisation:

Address:

Client's name:

Phone

Account ref:

Funded:

Legal aid

Local authority

Privately

Additional party no. 3 (if needed):

Contact name:

Position:

Organisation:

Address:

Client’s Name:

Phone

Account ref:

Funded:

Legal aid

Local authority

Privately

5. Result Details – Please include details of who will be receiving the results

Court date:(Required)

MM slash DD slash YYYY

Filing date:(Required)

MM slash DD slash YYYY

Additional result recipient(Required)

Yes

Contact name:

Position:

Organisation:

Address:

Phone

6. DrugPatch fitting – DrugPatch fitting will take place within a professional facility

Please note that a witness (i.e. a solicitor or social worker) must be present at all appointments. You will be contacted by Lextox to confirm availability for all necessary appointments.

6.1. Fitting Details:

MM slash DD slash YYYY

Preferred fitting dates (option 1)

Preferred fitting dates (option 2)

MM slash DD slash YYYY

Preferred fitting dates (option 2)

Witness name:

Witness position:

Witness contact number:

Address of fitting location:

7. Breath test set up: This will be undertaken by a Lextox Sample Collector only

You will be contacted by Lextox to confirm availability for all necessary appointments.

7.1. Where would you like the set up to take place?

Participants’ home

Office/Facility

7.2. Set up details (preferred set up dates):

MM slash DD slash YYYY

Option 1

Option 2

MM slash DD slash YYYY

Option 2

Witness name:

Witness position:

Witness contact number:

Address of set up location:

Download a quote form

Download our PDF quote form here

and email it to [email protected]

Why Lextox?

Enhanced facial recognition and missed test notifications

A robust, portable and discreet device

Direct contact with our Lextox experts, with over 100 years’ combined experience

Dedicated client managers who will manage your case from start to finish

The Breath Test explained

When a donor blows into the device, it tests for the detection of alcohol and the result is then sent to an online portal.

The Breath Test is easy-to-use and utilises enhanced facial recognition to ensure only donors use the device. The device is also portable so can be used anywhere to fit around the individual’s lifestyle, encouraging regular use from the donor.

This pioneering device is an excellent way to help prove ongoing abstinence, therefore, your Lextox dedicated client manager will work with you to create a 30, 60 or 90 day programme that best suits you and your client.