Personal Information
Tell us about yourself
Business & Payment
Leave blank if operating as a sole proprietor under your name
Driver's License
Must be a valid Texas license with a clean driving record
Upload front & back of your driver's license to our secure Google Drive folder
Open Secure Upload Folder ↗Vehicle Information
The vehicle you will use to transport patients
Insurance Information
Commercial auto insurance is required before your first trip
Upload your COI showing UltraCare Transport as additional insured
Open Secure Upload Folder ↗Background Check & Compliance
Required before your first trip
Upload background check report (completed within past 12 months)
Open Secure Upload Folder ↗Service Preferences
Tell us what rides you can accept
Independent Contractor Agreement
Please read the full agreement before signing
Independent Contractor / Subcontractor Agreement
ultracaretransport.com · info@ultracaretransport.com · Dallas–Fort Worth Metro
1. PARTIES
This Agreement is entered into between UltraCare Transport LLC ("Company") and the signing Contractor ("Driver/Partner"). The Company is located in the Dallas–Fort Worth Metro, Texas.
2. INDEPENDENT CONTRACTOR STATUS
Contractor is an independent contractor, not an employee, agent, or joint venturer. Contractor shall have no authority to bind UltraCare Transport, is solely responsible for all taxes on compensation received, and is not entitled to any employee benefits. UltraCare Transport will issue a Form 1099 if annual payments meet IRS reporting thresholds.
3. SCOPE OF SERVICES
Contractor agrees to provide NEMT services including transporting ambulatory and wheelchair-dependent patients to medical appointments, dialysis centers, assisted living facilities, and hospitals; providing door-to-door assistance; maintaining punctuality, professionalism, and patient dignity; and completing all required trip logs and documentation.
4. WHITE LABEL & BRAND REPRESENTATION
All services shall be rendered exclusively under the UltraCare Transport brand. Contractor shall not promote their own competing business to any UltraCare client or referral source and must refer all booking inquiries back to UltraCare Transport.
5. COMPENSATION & PAYMENT TERMS
Per-trip flat rates: Dialysis Ambulatory RT $60 · Dialysis Wheelchair RT $75 · Medical Appt Ambulatory RT $60 · Medical Appt Wheelchair RT $105 · Hospital Discharge (one-way) $65. After-hours/weekend surcharge: +$10. Wheelchair Assist Fee: +$5 per WAV trip. Payment is weekly every Friday via Zelle or direct deposit. No-shows and cancellations under 4 hours: 50% of trip rate. Disputed trips must be raised within 7 days.
6. VEHICLE & INSURANCE REQUIREMENTS
Contractor must maintain valid commercial auto insurance with minimum $1,000,000 combined single limit liability, provide a current COI prior to first trip, and maintain a properly registered vehicle. Lapse in insurance is grounds for immediate termination.
7. CONFIDENTIALITY & NON-DISCLOSURE
Contractor shall hold all patient data, pricing, business methods, and proprietary information in strict confidence. Contractor must comply with all applicable HIPAA and Texas privacy laws. Confidentiality obligations survive termination indefinitely.
8. NON-COMPETE & NON-SOLICITATION
For 12 months post-termination, Contractor shall not solicit UltraCare Transport's clients, patients, or partners within the Dallas–Fort Worth metro (Tarrant, Dallas, Collin, Denton, Rockwall, Ellis, and Kaufman counties).
9. PATIENT SAFETY & PROTECTION
Contractor shall treat all patients with dignity and respect, never leave a patient unattended without proper handoff, immediately report any injury or safety concern, never solicit tips or personal relationships from patients, and maintain a drug-free and alcohol-free status during all service hours.
10. BACKGROUND CHECK & COMPLIANCE
Contractor must provide proof of a background check within the prior 12 months, have no disqualifying felony convictions, not be listed on OIG LEIE or SAM.gov, and hold current CPR/First Aid certification (or obtain within 30 days).
11. TERM & TERMINATION
Either party may terminate with 7 days written notice. UltraCare Transport may terminate immediately for: insurance lapse, patient safety violations, HIPAA breaches, client solicitation, DUI/DWI, or false representations.
12. INDEMNIFICATION
Contractor shall indemnify and hold harmless UltraCare Transport from any claims arising from Contractor's negligence, misconduct, or violations of law. UltraCare Transport's total liability shall not exceed compensation paid in the preceding 30 days.
13. DISPUTE RESOLUTION & GOVERNING LAW
Governed by Texas law. Disputes resolved by: (1) good faith negotiation, (2) non-binding mediation in Dallas County, (3) binding arbitration under AAA Commercial Rules. Prevailing party recovers attorneys' fees. Contractor waives class action rights.
14. GENERAL PROVISIONS
This is the entire agreement between the parties. Amendments must be in writing and signed by both parties. Contractor may not assign this Agreement without written consent.
Final Review & Submit
Confirm all documents have been uploaded before submitting