Responsible Driver Program Registration and Informed Consent Registration Information (Mandatory fields please print clearly and use black or blue ink) SURNAME GIVEN NAMES BC Driver s Licence.

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How to fill out the Canada Stroh Health Care Responsible Driver Program Registration And Informed Consent online

Filling out the Canada Stroh Health Care Responsible Driver Program Registration And Informed Consent is an important step in ensuring your eligibility for the program. This guide will provide you with clear, step-by-step instructions to help you complete the form online efficiently and accurately.

Follow the steps to complete your registration smoothly.

  1. Click the ‘Get Form’ button to access the form and open it in the editor.
  2. Begin by filling in your personal information in the Registration Information section. Clearly print your surname and given names, and provide your BC driver’s licence number, date of birth (format: YYYY/MM/DD), and mailing address, including your city, province, and postal code.
  3. In the Telephone Contact section, provide your preferred phone number and select whether this number is for work or home. Additionally, if you wish to receive email communications, include your email address.
  4. Acknowledgement of the Responsible Driver Program Requirements requires you to confirm your referral by RoadSafetyBC. Ensure you understand that the program may take 9 months or longer to complete.
  5. In the Consent to Release Information section, acknowledge that RoadSafetyBC will send your driving record to Stroh and consent to the collection of your personal information by Stroh.
  6. Under the Acknowledgment and Agreement to Program Requirements section, read the details of what the telephone assessment will entail, as this will help determine the appropriate program for you.
  7. Review the Program Cost section and agree to pay the fee of $930.00 before participation. Select your method of payment, and ensure to provide necessary details if using a credit card.
  8. Submit the registration package as directed. If paying by cheque or money order, ensure it is made payable to Stroh Health Care and mailed to the specified address. For credit card payments, you may submit the completed form online or fax it as mentioned.
  9. Finally, check the box indicating your acknowledgement of understanding the program requirements and sign with the date as required.

Start filling out your Canada Stroh Health Care Responsible Driver Program Registration And Informed Consent form online today!

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