M2Z Employers Intake Form

M2Z COMPLIANCE SOLUTIONS
EMPLOYER — PREFERRED PARTNER NETWORK ENROLLMENT & PARTNERSHIP AGREEMENT FORM
Join the M2Z Preferred Employer Network to access full DOT compliance management, RTD case handling, Clearinghouse support, and a direct pipeline to pre-cleared CDL drivers ready to work. Free to join.
(888) 282-2279 | info@m2zcompliance.com | Sugar Hill, GA 30518
WHAT EMPLOYER PARTNERS RECEIVE - FREE: (1) Listed on the M2Z Preferred Employer Partner page — company name, location, industry, types of CDL positions, and contact info. (2) Full access to M2Z Employer RTD Management Program — $175/driver (member rate). (3) Consortium enrollment at flat annual fleet rates ($199-$599/yr). (4) Driver Compliance Binder for every enrolled driver. (5) Quarterly compliance check-in call — DQ files, Clearinghouse, random testing rates reviewed every 90 days. (6) Priority same-day case opening when a driver violation occurs. (7) Direct pipeline to RTD-cleared drivers seeking employment through M2Z recruiter and driver referral network.
Partnership is always free. No fees, no contracts, no minimums. M2Z asks only that you designate us as your C/TPA and use our RTD program before deciding to terminate a driver with a violation. Fields marked * are required.
COMPANY INFORMATION
Company / Business Legal Name*
DBA / Trade Name (if different)
Federal EIN / Tax ID
Company Website
Main Business Phone*
Format: (000) 000-0000.
Main Business Email*
example@example.com
Business Street Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
For-hire carrier, private fleet, or owner-operator operation.CDL drivers operating equipment or hauling materials.

PARTNER PRICING REFERENCE — YOUR RATES AS AN ENROLLED EMPLOYER

PARTNER PRICING REFERENCE — YOUR RATES AS AN ENROLLED EMPLOYER

Service	Price	Notes
DOT Urine Drug Test - Nationwide	$85	Member rate: $75
DOT Breath Alcohol Test (BAT)	$85	RTD client add-on: $75
DOT Drug + Alcohol Combo	$145	Both tests. Save $25.
DOT Physical - RTD Priority Rate	$105	Employers in RTD program
DOT Physical - Preferred Partner	$99	Consortium members only
DOT Physical - Standard Rate	$125	All new clients
Pre-Employment Clearinghouse Query	$25	Full query per new hire
Annual Clearinghouse Query	Included	Free for consortium members
Consortium - 2-5 Drivers	$199/yr	All drivers covered. Flat annual.
Consortium — 6-10 Drivers	$299/yr	All drivers covered. Flat annual.
Consortium - - 11-15 Drivers	$399/yr	All drivers covered. Flat annual.
Consortium — 16-20 Drivers	$599/yr	All drivers covered. Flat annual.
Employer RTD Case Management	$175/driver	Member rate. Non-member: $225.
RTD Complete Package (per driver)	$299	Drug test + Clearinghouse update.
Total Employer RTD Advance	$474	Case mgmt $175 + RTD pkg $299.
Follow-Up Compliance Program	$49/mo	Per driver. Driver pays M2Z direct.
Hair Follicle 5-Panel	$155	Volume rate: $140 (5+/mo)
Hair Follicle 10-Panel	$190	Volume rate: $170 (5+/mo)

Random pool management, Clearinghouse C/TPA designation, random selections at federal rates (50% drug/10% alcohol), driver notifications, compliance certificates, annuaM2Z builds and maintains Driver Qualification files for every driver. Tracks CDL and medical card expirations, pulls annual MVRs, manages violation certifications. Audit-readyM2Z designated as your C/TPA in the Clearinghouse. Pre-employment full queries ($25/driver), annual limited queries (included for consortium members), violation reporting.Pre-organized branded CDL compliance binder for every driver. Bundle discount: 1-5 drivers = all free with Consortium + DQ bundle. 6-10: first 3 free. 11-20: first 5 free.
M2Z Compliance Solutions | Registered C/TPA | HIPAA-Compliant | (888) 282-2279 | info@m2zcompliance.com
m2zcompliancesolutions.com | 1400 Buford Hwy NE, Suite F-4, Sugar Hill, GA 30518 | Form M2Z-EMP-NET-001 | © 2026

Option B - Self-Funded RTD Position held for 90 days. Driver covers all costs on their own. Driver must present M2Z green checkmark and follow-up enrollment to return.Decide case-by-case based on the driver and situation M2Z will present both options to you when a violation occurs
Yes - open a case immediatelyNo - enrolling proactively
Complete driver details below
Driver Name (if current violation)
Driver's CDL Number
Violation Type
Date of Violation

MonthDayYear
Date
Drug / Alcohol / Refusal
Has driver started SAP process?
SAP Name (if known)
PREFERRED EMPLOYER PARTNER LISTING PREFERENCES
Your company will be listed on the M2Z Preferred Employer Partner page. This helps RTD-cleared drivers and recruiters find employers who are open to post-RTD drivers and who use M2Z for compliance management. Tell us exactly how you want to be represented.
Company Name for Listing (as it should appear on M2Z website)**
One-Line Description (Optional)
Website for Listing Link
Phone # to Display
Format: (000) 000-0000.
Email for Listing (Optional)
example@example.com
Currently Hiring CDL DriversOpen to Post-RTD / SAP DriversClass A CDL PositionsClass B CDL Positions
M2Z Compliance Solutions | Registered C/TPA | HIPAA-Compliant | (888) 282-2279 | info@m2zcompliance.com m2zcompliancesolutions.com | 1400 Buford Hwy NE, Suite F-4, Sugar Hil, GA 30518 | Form M2Z-EMP-NET-001 | ©2026

We authorize M2Z to list our company on the Preferred Employer Partner page Listing will include information as provided in Section G aboveAll information provided on this form is accurate and complete M2Z will use this information to set up your partner account and Clearinghouse designationWe have read and agree to the M2Z Terms & Conditions, Privacy Policy, and Partner Guidelines Full policies available at m2zcompliancesolutions.com - copies available upon request
AUTHORIZED SIGNATURE
By signing below the authorized representative of the company confirms that all information is accurate, they have authority to enter into this partnership and designate M2Z as C/TPA on behalf of the company, and they agree to all terms acknowledged in Section H.
Authorized Signatory - Typed Full Name **
Date **

MonthDayYear
Date
Title / Position **
Company Name (confirm) **
WHAT HAPPENS AFTER YOU SUBMIT: (1) M2Z reviews your enrollment within 1 business day. (2) Your dedicated M2Z partner contact reaches out to confirm your Clearinghouse designation, listing details, and program setup. (3) Your company is listed on the M2Z Preferred Employer Partner page. (4) If you have an active driver violation, M2Z opens the case that day. (5) Your first quarterly compliance check-in call is scheduled within 30 days. Questions? Call (888) 282-2279—we answer the phone.
FOR OFFICE USE ONLY
Received By
Date Received
Partner Account #
Listing Live Date
Clearinghouse Set Up
Consortium Enrolled
Welcome Email Sent
Assigned To
RTD Case Opened (if applicable)
1st Quarterly Call Scheduled
Internal Notes
Should be Empty:

M2Z COMPLIANCE SOLUTIONS

EMPLOYER — PREFERRED PARTNER NETWORK ENROLLMENT & PARTNERSHIP AGREEMENT FORM

COMPANY INFORMATION

B PRIMARY CONTACT — COMPLIANCE COORDINATOR

C FLEET & DRIVER INFORMATION

D CURRENT DOT COMPLIANCE STATUS

E M2Z SERVICES REQUESTED Check all that apply

PARTNER PRICING REFERENCE — YOUR RATES AS AN ENROLLED EMPLOYER

F EMPLOYER RTD MANAGEMENT PROGRAM Complete if applicable

PREFERRED EMPLOYER PARTNER LISTING PREFERENCES

PARTNERSHIP TERMS & ACKNOWLEDGMENTS

AUTHORIZED SIGNATURE

FOR OFFICE USE ONLY