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About AZC
Our Difference
Services
Drug & Alcohol Testing Programs
DOT Drug & Alcohol Compliance
FAA - Federal Aviation Administration
FMCSA - Federal Motor Carrier Safety Administration
FRA - Federal Railroad Administration
FTA - Federal Transit Administration
PHMSA - Pipeline & Hazardous Materials Safety Administration
USCG - United States Coast Guard
Consortium Enrollment
Drug Free Workplace
Motor Carrier Compliance
FMCSA DOT Clearinghouse
Drug & Alcohol Testing Training
Background Screening
Onsite & Mobile Testing
Personal Drug Testing & DNA Testing
Resources
Drug and Alcohol FAQs
Reviews
Contact
About AZC
Our Difference
Services
Drug & Alcohol Testing Programs
DOT Drug & Alcohol Compliance
FAA - Federal Aviation Administration
FMCSA - Federal Motor Carrier Safety Administration
FRA - Federal Railroad Administration
FTA - Federal Transit Administration
PHMSA - Pipeline & Hazardous Materials Safety Administration
USCG - United States Coast Guard
Consortium Enrollment
Drug Free Workplace
Motor Carrier Compliance
FMCSA DOT Clearinghouse
Drug & Alcohol Testing Training
Background Screening
Onsite & Mobile Testing
Personal Drug Testing & DNA Testing
Resources
Drug and Alcohol FAQs
Reviews
Contact
Everdriven Drug and Alcohol Consortium Program
EverDriven
Date
*
Membership Fee for Covered Services
*
Annual Membership Fee: $50.00
Pre-Employment Drug Test Required
*
Drug Screen Charge: $45.00
Service Provider
Service Provider / Company Name
*
Service Provider Mailing Address
*
Service Provider Mailing Address
Service Provider Mailing Address
Include Apartment/Suite Number if Applicable
Include Apartment/Suite Number if Applicable
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Service Provider Designated Employer Representative (D.E.R.)
D.E.R. Name
*
D.E.R. Name
First
First
Last
Last
D.E.R. Phone Number
*
D.E.R. Email
*
Employee Driver / Monitor
Employee First & Last Name
*
Employee First & Last Name
First
First
Last
Last
Employee Driver's License Number
*
Employee Driver's License State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Employee Phone Number
*
Employee Zipcode
*
Total
If you are human, leave this field blank.
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