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About Us
Our Service
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Drive With Us
Call Us Today!
Call Us Today!
Home
About Us
Our Service
Life Sciences
Drive With Us
Home
About Us
Our Service
Life Sciences
Drive With Us
Drive With Us
Driver / Courier Application Form
First Name
Last Name
Email
Phone
City
State
Are you over the age of 21?
Yes
No
Do you own or lease a vehicle?
own
lease
Borrow
What type of vehicle do you drive?
Cargo Van
Car
SUV
Mini Van
What make is your vehicle?
What model is your vehicle?
2010 or Older
2011-20215
2016-2020
2020+
Is your phone less than 5 years old?
Yes
No
Are you able to carry at least 50 pounds?
Yes
No
What days of the week are you available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What time of day are you available to provide service?
Mornings
Afternoons
Evenings
Overnight
Are you a United states Citizen?
Yes
No
Do you have a valid driver's license?
Yes
No
Did you receive your first driver's license within the last 12 months?
Yes
No
Do you have an active automobile insurance policy?
Yes
No
If yes, are you listed as a driver on the policy?
Yes
No
Have you ever been "CONVICTED" of driving under the influence (DUI) ?
Yes
No
In the last 5 years, have you received any moving violations?
Yes
No
If yes please state the nature of the moving violation and the date of the violation
Some Red Fox customers require to be drug tested in order to perform delivery services. Would you be willing to submit a drug test to make deliveries for these customers? *
Yes
No
Why are you interested in becoming a driver for Red Fox?
When are you available to start?
When are you available to start?
By checking this box, I consent to receive automated reminders and service-related messages from Red Fox Medical Courier at the phone number and/or email I provided above. These may include appointment reminders, order confirmations, account notifications, and similar messages. Message and data rates may apply. Frequency may vary. Reply HELP for assistance or STOP to opt‑out at any time.
When are you available to start?
I confirm that I have read and agree to the Privacy Policy and Terms of Service.
Done
Terms of Service
Privacy Policy
