Drug Consortium Enrollment

3d DRUG CONSORTIUM

Drug & Alcohol Testing Program Account Set-up Form
Company Name*
DOT # (if Applicable)
If DOT Regulated, Enter your DOT number
Physical Address (no PO Boxes)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Add a Mailing Address?

YesSame as Physical Address
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Phone Number

Area CodePhone Number
Primary Contact Name*

First NameLast Name
Primary Contact Title*
Primary Contact Phone*

Area CodePhone Number
Primary Contact Permissions*

Receive Results via emalReceive Results Notification onlyBilling ContactView Results onlineCan order TestsIs DER-Designated Employer Representative
Primary Contact E-mail*
Secondary Contact Title
Inlcudes the following:

Drug Free Workplace Policy Manual or ProgramDER (Designated Employer Representative) TrainingRandom Program ManagementDOT Random Consortium
Notes or Additional Contacts
DOT RANDOM DRUG & ALCOHOL CONSORTIUM PROGRAM SERVICE AGREEMENT

Alol Solutions adheres to Department of Transportation (DOT) Regulations regarding 49 CFR Part 40 of all DOT agencies.

The employer is responsible for staying in compliance with the department of Transportation regulations. The employer must provide Alol Solutions with driver information to complete required testing.

Membership includes pre-employment and random testing. Additional fees are required for supervisor training, SAP Programs, follow-up testing, and its administration. Alol Solutions will act as an intermediary in transmitting the information from the other service agents to the DER of the employer per the Appendix F of the 49 CFR Part 40 procedures.

We will retain all associated DOR required records during the service period and will provide these records upon request at no charge upon membership termination. Required records not received by this consortium will be the responsibility of the member (eg: MRO records sent to the enrolled not forwarded to us)

I hereby agree to participate in the Alol Solutions Drug Consortium Program and further agree to abide by its rules, policies, and procedures.

My Products*

Drug Consortium Owner Operator$199.00

Includes 1 Pre-employment and One Random per rolling 12 months. Additional tests $85 per test.

Drug Consortium Fleet Owners$299.00

Includes 3 pre-employment and 3 randoms per year. Additional tests $85 per test.

Total $0.00

Payment Methods

Credit Card

Apple Pay

Cash App Pay

Afterpay

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