DOT Consortium Enrollment

Need help? Call DOT Clinic at 904-515-3570

Step 1: Choose Enrollment Type

Pick one option to continue.

Single Driver Owner-Operator

You own or drive your own truck, no employees.

Company Enrollment (0-9 Employees)

Small company enrollment for businesses with 0-9 employees.

Company Enrollment (10-29 Employees)

Company enrollment for businesses with 10-29 employees.

Company Enrollment (30-59 Employees)

Company enrollment for businesses with 30-59 employees.

Company Enrollment (60-99 Employees)

Company enrollment for businesses with 60-99 employees.

Company Enrollment (100-149 Employees)

Company enrollment for businesses with 100-149 employees.

Company Enrollment (150+ Employees)

Large fleets require a quick call with DOT Clinic for setup and pricing.

Step 1: Enrollment Form

Complete the information below, then continue to Step 2 payment.

Primary Contact

First Name

Last Name

Phone

Address

Address 2

City

State / Territory

Zip Code

Designated Employer Representative (DER)

DER is the same as the primary contact

DER First Name

DER Last Name

DER Phone

After submitting Step 1, you will go to Step 2 payment.

Retail Pricing

Enrollment Summary

Selected Option Choose an option

Due Today $0.00

Annual Renewal $0.00

Company enrollment: Step 1 form, Step 2 payment.

What You Get

DOT-compliant consortium enrollment
Consortium administration
Random selection management
Annual renewal on the same date each year
DOT Clinic support