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Onboarding Questionnaire
Thank you for considering
ITSA
for your TPA needs! Please answer the following questions and someone will get with you right away. If you have any questions please call the office at
586-991-0000
.
Thank you and have a great day!
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Email
*
Your email
Company Name
*
Your answer
Address
Your answer
Phone Number
*
Your answer
Name of person filling out this form:
*
Your answer
How did you hear about ITSA?
Your answer
Type of Program Needed:
DOT
Non-DOT
Both
Not sure
Clear selection
If DOT, What agency? Select multiple if needed:
FAA
FTA
FRA
FMCSA
PHMSA
USCG
Is this a current DOT or a new DOT Program?
Current
New Program
Clear selection
How many people are in the program?
Your answer
How many locations do you have?
Your answer
IF FMCSA, do you need Clearinghouse reporting from C/TPA?
Yes
No
Clear selection
Do you need Background Checks? (Example: 40.25, PRIA)
Yes
No
Clear selection
Non DOT Program requirements: (What testing panel, randoms required?)
Your answer
Do you need a DOT written policy?
Yes
No
Not sure
Clear selection
Do you need a Non-DOT written policy?
Yes
No
Not sure
Clear selection
Additional notes or questions:
Your answer
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