SAP Registration Form

Use the form below to register for an appointment with a licensed Substance Abuse Professional

Important FMCSA Clearinghouse Reminder

You will need to select Dr. Momtahan as your Evaluator through the FMCSA Clearinghouse to be approved for an SAP Evaluation. This is required by the US DOT and your Employer. On the FMCSA Clearinghouse, please see our listing under Dr. Mohammad “Mo” Momtahan. FMCSA Clearinghouse Website ➤

Appointment Information

Enter the information below as it would appear on your Driver's License or State Issued Photo ID. If you have a DDS Identification Card, the ID Number is the same as your License Number.
Verify that your phone number and e-mail are correct!(Required)
Attach a copy of your photo ID below or e-mail it directly to [email protected]. You can scan in your ID or take a clear photo with your smartphone camera.
Max. file size: 50 MB.
Reminder: After payment, you will need to select Dr. Mohammad Momtahan on the FMCSA Clearinghouse. If you have any questions regarding this process, please contact our team members at 770-769-7279(Required)
Credit Card(Required)
American Express
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date