Welcome to
carGO Health!

We’re thrilled to have you join our team and look forward to building a strong and lasting partnership.

Please complete the following form in full. All information is required unless marked as optional.

Driver onboarding form

"*" indicates required fields

1. Personal Information

First Name*

Last Name*

Date of Birth*

Social Security Number or EIN*

Primary Phone Number*

Email Address*

Phone Type*

Service Provider*

Uniform Shirt Size*

Uniform Jacket Size*

2. Mailing Address

Address Line 1*

Address Line 2 (e.g. Apt/Suite)*

City*

State*

ZIP Code*

3. Emergency Contact

Full Name*

Relationship to You*

Emergency Contact Phone Number*

4. Vehicle Information

Primary Vehicle

Vehicle Type*

Vehicle Ownership*

Make*

Model*

Year*

Please enter a number from 1000 to 9999.

License Plate State*

License Plate Number*

Secondary Vehicle

Do you have a secondary vehicle?

Do you have a Secondary Vehicle?

Vehicle Type*

Vehicle Ownership*

Make*

Model*

Year*

Please enter a number from 1000 to 9999.

License Plate State*

License Plate Number*

5. Driver’s License

Issuing State*

Driver’s License Number*

Expiration Date*

6. Upload a Headshot / Profile Picture

For your driver ID and internal profile*

Max. file size: 50 MB.

Acknowledgment

I acknowledge that all information provided above is true and accurate. I understand that providing false or misleading information may result in termination of my contract with carGO Health.*

I acknowledge that all information provided above is true and accurate. I understand that providing false or misleading information may result in termination of my contract with carGO Health.

Phone

This field is for validation purposes and should be left unchanged.

Welcome to carGO Health!