Order form | Falck (f. Previa)

Service

Company

Orderer

Name (orderer)

Employee

How many persons is the order for? One person A group

Attach the list of personal data in a separate document and upload it below. Use the template for group orders. (download template)

Swedish social security number Yes No

Risk assessment

Source of risk

Exposure

Work tasks

Attach any risk assessment below with file upload.

Other

Delivery city This field is required.

Specify the immediate manager who will be the recipient of the first-day certificate…

Additional recipient of certificate or feedback No Yes

Message

Attach any risk assessment below with file upload.

Attach a copy of the decision for first day certificate. (PDF)

To attach multiple files: hold "ctrl" or "cmd" and select all the files you want to include in the order.

File upload

Send

All data is sent with a secure connection. In the next step, you can save a summary of the order as a pdf. Confirmation to employees is sent as a text message.

Send

All data is sent with a secure connection. In the next step, you can save a summary of the order as a pdf. Confirmation to employees is sent as a text message.

Drug test answers: If the service includes a drug test, a negative test result will be notified in email titled "Result of test <order number>" from noreply@Infosolution.se

About personal data: As a customer, you are responsible for providing correct information to ensure the handling of personal information when ordering, booking and invoicing. Please read our Privacy Policy.