Form
Sentinel Dispatch Services LLC
CLIENT INTAKE FORM
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SECTION 1 — BUSINESS INFORMATION
Legal Business Name
*
DBA (if applicable)
Business Address
*
Business Phone Number
*
Business Email
*
SECTION 2 — OWNER / AUTHORIZED REPRESENTATIVE
Full Name
*
First Name
Last Name
Title / Role
Direct Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
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SECTION 3 — DISPATCH SERVICE SELECTION
Service Selection (IMPORTANT)
Which level of dispatch support are you looking for?
*
Basic Dispatch
Intermediate Dispatch
Priority Dispatch
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Section 3: Authority Status
Do you have active operating authority?
Type a question
*
Yes
No
In the process
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Section 5: Equipment Type
What type of equipment are you running?
Type a question
*
Dry Van
Reefer
Flatbed
Box Truck
Power Only
Other
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Section 6: Preferred Lanes
Example: Phoenix to Texas, Local AZ, OTR, West Coast, etc.
What lanes do you prefer to run?
*
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Section 7: Start Time
When are you looking to start dispatch services?
*
Immediately
Within 1 week
Within 2–4 weeks
Just exploring
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Section 8: Final Question
Is there anything else you would like us to know about your operation?
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