Sign-up for Service

Sign-up for Service

'Enter Information | Submit Payment'
Name (as it appears on your DL)

First NameLast Name
Email
Make sure it's correct.
Phone Number
Format: (000) 000-0000.
Date of Birth

MonthDayYear
Enter your CDL#
Make sure it's correct.
Issuing state of your CDL
TX, FL, NY, examples
Current Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
**ATTENTION** If you are a driver signing-up, you MUST upload a screenshot showing your SAP's full name, email, and date of your 'RTD Test w/ Negative Result' (if applicable). Upload the image by: logging in to your Clearinghouse account, clicking 'View RTD Process Details' button, taking a screenshot, and then 'drag-and-drop' it below:
*Confirm: enter the Substance Abuse Professional's full name (as shown in your screenshot above)
SAP's First and Last Name
*Confirm: enter the Substance Abuse Professional's email (as shown in your screenshot above)
SAP's email
Select the number of 'open violations' in your Clearinghouse:
Select the service you're paying for now:

USD