Drivers | Pharmed Logistics

Independent Contractor Opportunity Form

Please provide your details to apply for a professional driving position within our medical logistics network.

First Name

Last Name

Email

Phone

City of Residence

State of Residence

Are you eligible to work in the United States?

Yes

No

Do you have a registered business and EIN?

Yes

No

What type of vehicle do you own?

Please provide make, model, and year of vehicle chosen above

Do you consent to be contacted by PharMed Logistics for contracting opportunities?

Yes

No

Have you provided courier services in the past?

Yes, standard courier services

Yes, medical courier services

No

Do you have a valid driver's license?

Yes

No

Do you have up-to-date certifications required for medical transportation?

Yes

No

Are you willing to submit to a background check and drug testing to be considered for a contracting opportunity?

Yes

No

How many days per week are you available for contracting opportunities?

What day(s) are you unavailable for contracting opportunities?

Do you have specific time(s) you are unavailable for contracting opportunities?

Start Date

By checking this box: I authorize PharMed Logistics to store the information submitted in this form and to contact me using said information for contracting opportunities; I understand submission of this form does not guarantee I will be contacted or offered any contracting opportunities; I acknowledge that I am submitting this form for contracting opportunities as an independent contractor to PharMed Logistics; I have read the Independent contractor information provided above.

Driver Opportunities

Independent Contractor Opportunity Form