Safety Plus Employee Processing Registration

Safety Plus Employee Processing Registration
IMPORTANT UPDATE: This form link has changed. Be sure to update any saved bookmarks you may have to this new link.
Please complete this form to notify the Safety Plus team that you are sending an employee to our EP office for training/orientation, drug screens, fit tests, or other services. This form does not include any Evonik services.

ENSURE THIS FORM IS COMPLETE 30 MINUTES PRIOR TO THE EMPLOYEE'S ARRIVAL to allow time for our team to prepare and avoid an additional registration fee.

Operating Hours

Our Employee Processing operating hours are 8:00am-1:00pm Monday - Friday. If an employee is completing a New Hire Orientation training program, they must arrive before 10:00am.

Our offices close for the following holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Friday following Thanksgiving, Christmas Eve, Christmas Day.
Company Name*
Requested By*

First NameLast Name
Email*
Phone Number
Date of Service(s)*

MonthDayYear
Date
Upload Employee Form

Select "Browse Files" to upload more than one document to this form submission.
Cancelof
Employee Information

If you have uploaded a completed Employee Form above, you do not need to fill out the rest - just go ahead and submit! If each employee will be receiving different services, please upload an employee form, complete this registration separately for each employee, or provide detailed notes below.
Employee Name(s)
Total Number of People
Services

Please select the services that you wish for us to perform for all employees listed above. Again, if each employee requires different services, complete a separate entry for each or provide detailed notes below.
Services

Drug Screen - Federal - CDL DriverAlcohol Screen-FederalDrug Screen-Non-Federal - non-CDL DriverAlcohol Screen-Non-FederalDrug Screen-Quick Screen (10 Panel)Clearinghouse RegistrationClearinghouse QueryDOT Driver FileDriver's License CopyDOT Physical AuthorizationDOT Medical Card CopyTraining-New Hire OrientationTraining-Other Courses (specify in notes)Social Security Card CopyBackground CheckMVR (Motor Vehicle Report)Badge/Employee CardRespiratory Medical Clearance & Fit Test-Full Face Qualitative (specify mask in notes)Respiratory Medical Clearance & Fit Test-Full Face Quantitative (specify mask in notes)Respiratory Medical Clearance & Fit Test-Half Face Qualitative (specify mask in notes)Respiratory Medical Clearance & Fit Test-Half Face Qualitative (specify mask in notes)Hearing TestingOther
Reason for Drug/Alcohol test
DOT Agency
Notes
Should be Empty:

Safety Plus Employee Processing Registration

Employee Information

Services