CLIENT INTAKE

Please fill out your contact information

This must be completed before I can proceed any further with getting your lab orders, sap reports, schedule evaluations. You do not have to make a payment now, I will send an email once I receive your submission.
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Upload A Picture of Your CDL

Cancelof
OR ... you can type your CDL #
Has your CDL been downgraded? Have you got a letter from DMV saying your license will be downgraded?
Are we looking at a specific date by which we should try to beat?
Type in any contact information for your SAP, HOPEFULLY you can request the copy of your follow up plan be sent to me without issues. Some are particular. If you were referred by a SAP they usually will be just fine with you asking them to forward your plan on over, you can request your follow up plan be sent to me at: returntodutynow@yahoo.com
***YOUR SAP MAY WANT YOU TO PROVIDE CONSENT TO SEND YOUR FOLLOW UP PLAN TO YOUR "EMPLOYER" PLEASE HAVE THEM SEND YOUR FOLLOW UP PLAN TO SHELBYCOMPANYLIMITED@MAIL.COM -- DOT NUMBER IS 4198225 [Yes, I really do have trucks.]
What do you need to complete ?

Return to Duty Test OnlyFollow up Testing OnlyReturn to Duty and Follow UpsReport Return to Duty ResultsPartial Completed Follow Up PlanOther
**PLEASE BE AWARE**

Follow up testing cannot be marked as completed in the Clearinghouse within 180 days of your Return to Duty test date. For Example: If you took your return to duty test 01/01/2025, your follow up completion date can be no sooner than 06/31/2025 -- This is a new update to the Clearinghouse system and cannot be overridden, unfortunately.

There is an email that you will receive after you submit this form which will be for your SAP Follow Up plan to be released with your permission. Once you get the email for REQUEST TO RELEASE, the request will automatically be sent to your SAP and reduce the amount of processing time, all you need is the email address of your SAP provider.
Have you completed your return to duty test already? If so, what was the date?

MonthDayYear
If no, leave blank.
If you selected, a return to duty drug screen or a follow up test, how soon would you like to start?

MonthDayYear
Date
If doing follow-up testing, what is your preferred testing frequency?
This is only to get an idea of how often you would PREFER to be tested and what works best for you and your budget.
You can schedule a free phone Consultation to answer any questions you may have. Select a date and time below:
Is there any additional information you would like to ask about or any details that you would like to provide about your circumstance?
THANK YOU !!!

You can text me at 502-858-3608

Email at returntodutynow@yahoo.com or contact@rtdpro.com

My website is www.rtdpro.com

And if you are ready to make a payment you can do so on the next page ...
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Please fill out your contact information