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Driving Assessment - $200
Thank you for choosing us for your driving assessment. Please fill out all questions so we have a clear understanding of your situation. Make sure we have the correct email/phone of the person who should be contacted for scheduling the assessment. After you have completed this form, we will contact you.
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Assessement Process:
The Driver being Assessed must have a valid driver's license (or permit). Unless another arrangment is needed, your driving assessment will be done in your personal vehicle. You must have valid insurance on your vehicle as our insurance doesn't cover your vehicle. The person needing the assessment should be comfortable driving that vehicle so we can properly assess them. Please confirm you understand this.
*
Yes, I understand the assessment will be done in our personal vehicle and we are property insured.
We need to use a training vehicle for the assessment ($30 additional charge).
No, I don't understand. Please contact us with further explaination.
Other:
Location of Assessment
*
Wisconsin (Coolee Region)
Minnesota (Rochester Area)
Other:
Type of Assessment Needed
*
Injury or Medical Condition
Age or Family Concern
New Teen or Adult Driver
Transportation Employee Assessment
Full Name
*
"Please include the first and last name of the person being evaluated"
Your answer
Home Address
*
"Please include a full mailing address"
Your answer
Email Address
of person who will arrange scheduling.
*
"please double check to make sure you entered it correctly"
Your answer
Phone Number
*
"please double check to make sure you entered it correctly"
Your answer
What method would you prefer to be contacted by IDA?
*
Phone
Email
Please explain the reason for an assessment.
Your answer
How soon would you like the assessment to be done?
*
"please choose the appropriate time line"
within 1 week
1 - 2 weeks
Within the Month
No hurry
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