M2Z LABS & SCREENINGS DBA M2Z COMPLIANCE SOLUTIONS
1400 Buford Hwy NE, F4 Sugar Hill, GA 30518               1-888-282-2279 | www.m2zcompliance.com

◆ IMPORTANT — PLEASE READ BEFORE PROCEEDING
Thank you for choosing M2Z Compliance Solutions to assist with your Return-to-Duty process. Before we can begin, please confirm the
following:

1. You must have completed Steps 1–4 in the FMCSA Drug & Alcohol Clearinghouse before we can work with you.
2. If you still need a Substance Abuse Professional (SAP), visit our website for a referral list.
3. Once Steps 1–4 are confirmed, we will act as your C/TPA and coordinate your Return-to-Duty drug screen.
4. After form submission and payment, our team will: (a) request your SAP final evaluation and follow-up testing plan, (b) walk you
   through designating us as your C/TPA in the Clearinghouse, and (c) create your donor pass for testing.

CONFIDENTIAL—Return-to-Duty Consortium/Third-Party Administrator Consent Form
Page 1 | M2Z Compliance Solutions | FMCSA Registered C/TPA | 1-888-282-2279

1400 Buford Hwy NE, F4 Sugar Hill, GA 30518                    1-888-282-2279 | www.m2zcompliance.com

Upload Both Sides of Your Driver's License
A clear, legible copy of your driver's license — front AND back — is required before your RTD test can be scheduled.
How to upload via QR Code:

1. Point your phone camera at the QR code →
2. Tap the link that appears on your screen
3. Upload both photos of your license (JPG, PNG, or PDF)

Files are received securely by M2Z Compliance Solutions staff only.

I understand that all Return-to-Duty drug tests are observed. 'Observed' means a collector of the same sex must directly observe the urine specimen leaving my body and entering the collection container, as required under 49 CFR Part 40.

I authorize the release of my confidential health information from my Substance Abuse Professional (SAP) to M2Z Labs & Screenings DBA M2Z Compliance Solutions, including but not limited to:

• Initial assessment and evaluation
• Recommended treatment plan
• Completion documentation
• Follow-up testing plan

Authorized Representative: LaTasha Syms | Phone: 1-888-282-2279 | Address: 1400 Buford Hwy NE, F4, Sugar Hill, GA 30518

CONFIDENTIAL—Return-to-Duty Consortium/Third-Party Administrator Consent Form Page 2 | M2Z Compliance Solutions | FMCSA Registered C/TPA | 1-888-282-2279

M2Z LABS & SCREENINGS DBA M2Z COMPLIANCE SOLUTIONS
1400 Buford Hwy NE, F4 Sugar Hill, GA 30518 •         1-888-282-2279 • www.m2zcompliance.com

• The goal of the FMCSA Return-to-Duty process is to ensure the safety of our nation's roadways.
• If I fail, refuse, substitute, or otherwise violate the testing process at any point, I must restart the entire RTD process and a new violation may be recorded.
• I understand I should NOT begin this process if I believe I will fail the drug test.
• A positive RTD result requires restarting the full Return-to-Duty process.
• Passing the RTD test is required before I may be removed from 'prohibited' status in the Clearinghouse.
• Results are typically available within 1-5 business days following the completed collection.

CONFIDENTIAL—Return-to-Duty Consortium/Third-Party Administrator Consent Form
Page 3 | M2Z Compliance Solutions | FMCSA Registered C/TPA | 1-888-282-2279

M2Z LABS & SCREENINGS DBA M2Z COMPLIANCE SOLUTIONS
1400 Buford Hwy NE, F4 Sugar Hill, GA 30518 • 1-888-282-2279 • www.m2zcompliance.com

Please select your preferred payment option below, and we will send you the appropriate secure Stripe payment link to complete your payment. Your program will officially begin once payment has been successfully confirmed.

All sales are FINAL. Payments are non-refundable, non-cancelable, and non-transferable. Services are rendered upon payment confirmation. M2Z Compliance Solutions reserves the right to refuse service.

By engaging our services, you acknowledge that M2Z Labs & Screenings DBA M2Z Compliance Solutions maintains detailed records including signed consent forms, drug test results, email and SMS communications, and all service-related documentation. These records are retained to protect the company against disputes and chargebacks. Charges may appear on your statement as M2Z Labs & Screenings or M2Z Compliance Solutions.

By signing below, I certify that: (a) I am the individual submitting this form, (b) all information provided is true, accurate, and complete, and (c) I have read, understand, and agree to all terms, disclosures, and authorizations contained herein.

CONFIDENTIAL—Return-to-Duty Consortium/Third-Party Administrator Consent Form
Page 4 | M2Z Compliance Solutions | FMCSA Registered C/TPA | 1-888-282-2279