Compliance Support Intake Questionnaire Let’s work together Company Name * (If you are an owner-operator without a company name, please enter your full legal name.) USDOT # Physical Address * Mailing Address (if different) Primary Contact Name * Primary Contact Phone Number * Primary Contact Email * Type of Operation (check all that apply) * Private (not-for-hire) For-Hire Motor Carrier Interstate Intrastate Only What do you typically transport? * Number of Power Units (truck-tractors, pickups, vans, etc.) * Number of Trailers * Do you anticipate expanding your fleet or hiring additional drivers within the next 12 months? * Yes No Services of Interest (Check all that apply) * Safety Policy or Manual Development Monthly/Quarterly DOT Compliance Review Risk Management Assessment(s) Driver Qualification File Management FMCSA Clearinghouse Setup & Queries Drug & Alcohol Testing Program (Consortium Enrollment) Hours of Service (HOS) Support CSA Score Monitoring & Management Driver Safety Training Other Have you had a DOT audit, inspection, or compliance review yet? * Yes No Do you currently use any fleet management software or ELD system? * Yes No Do you prefer a monthly support plan or a one-time compliance setup? * Monthly/Ongoing Support One-Time Setup Not sure yet Preferred timeframe to begin service * ASAP Within 2-4 weeks Later Thank you! We’ve received your information. Thanks for taking the time to complete the intake form. We’ll review your responses and get back to you shortly with a tailored quote or proposal based on your operation’s needs. If we have any follow-up questions, we’ll reach out directly. In the meantime, if you need anything or want to talk sooner, feel free to contact us at info@fleetsafetyexpert.com. We look forward to helping you stay compliant and safe on the road. — FleetSafetyExpert.com
