Substance Abuse Program Participation Form

There is a $350 annual fee per company and includes an unlimited number of card managers. It’s easy to participate. Simply complete the form below. If you are unsure if your company is a participant please contact Paige Riley at paige@ccs-safety.org. Please note this is separate from any fees you are paying your TPA such as DISA.

Note: The search above is case sensitive. When you find a match please click the “That’s Us” button below so we can match up to your record.
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