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By Andrew Horn | June 4, 2020

6582 Boll Weevil Circle
Enterprise, AL 36330

RAD IS HERE TO HELP

Feel free to contact us regarding drug and alcohol testing, ordering drug tests, questions about our products, finding a facility, or our workplace safety training. Call us toll free (916) 520-0244 or fill out the form below.

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(916) 520-0244

1435 N. Market Blvd.
Suite #11
Sacramento, CA 95834

info@radtesting.com

Business Hours: 24/7

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Privacy Policy, Terms & Conditions, Additional Product Terms

DOT Consortium Program Enrollment Form

Step 1 of 2

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Company Name:*
Step 1: Contact Information:
Contact Name:*
Address 1:*
Address 2:
City:*
State:*
Zip:*
Phone:*
Fax:
Cell Phone:
E-mail Address:*
Company DOT Name:
DOT #
Consortium Type: Check 1 box only, Designated Employee Representative (DER) information is required*
*
- Owner Operator
- Company with 2 or more Drivers to enroll in Consortium Pool
- Company with 100 or more Drivers for a Stand-Alone Random Pool
Owner Operator:*
Driver Name:*
Driver SSN or Employee ID:*
DER Name:*
DER Phone #:*
DER Cell #:*
DER E-mail:*
* DOT pre-employment drug test must be completed before driver is added to random pool.

Step 2: Choose Enrollment Package:
*
- Basic Package ($100)
  - 1-Year Enrollment in Randoms
  - Certification of Enrollment
  - Paper CCFs or Electronic CCFs
  - $60 Drug Test / $50 Breath Alcohol
- Compliance Package ($300)
  All Benefits of Basic Package plus:
  - 2 Free Drug Tests
  - DOT Policy
  - Required Supervisor Training
  - Part 40.25 Form (Required for all drivers)
Optional Add On
*
- 2 Additional Years of Enrollment ($100)
- Part 40.25 Form ($25)
- Supervisor Training ($50/each)
- Paper Copies of 49 CFR Part 40 & 382 ($25)
- DOT Policy ($75)
- DOT Pre-Employment Drug Test ($60)
- No Additional Add-Ons = $0.00
All fees must be remitted with this form.
Add all columns on front and back on this form.
Step 3: Payment:
Please Proceed to the shop page to purchase your desired package. Your application will not be processed without purchase.
*
- Card Holder Signature I agree
- I have read and agree to the website Terms and Conditions
- I have read and agree to the website Additional Products Terms

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RAD IS HERE TO HELP

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Purchase Products

DOT Consortium Program Enrollment Form

Step 1 of 2

Step 1: Contact Information:

Step 2: Choose Enrollment Package:

Optional Add On

Step 3: Payment: