In order to get started you will need the following information
Individual
- Contact Information
- Social Security Number
- Drivers License Number
Vehicle
- VIN Number
Beneficiary
- Contact Information for the Recipient
Contracting Company
- Username
- Password
Business (If Applicable)
- Name and EIN Number
Your Time
- Completion of this process takes between 15 and 30 minuntes to read and complete the enrollment documents.
Language Option & Legal Agreement
All instructions can be translated to one of the languages below. However, all contracts are in English and you have 72 hours to rescind any signatures.
Language Option:
I DO NOT wish to enroll using the online method. I would rather enroll using paper documents
I AGREE to use the CMS Independent Contractor Online Enrollment System. I understand this system takes advantage of CMS Click-to-Sign Technology using an electronic signature to sign legal documents and is E-Sign Act compliant.
In order to continue your enrollment using this online method, you must agree to the terms and conditions for use of the CMS Online Enrollment System. This platform takes advantage of CMS Click-to-Sign Technology that implements an electronic signature to sign legal documents.
If you would rather use an alternative method, please contact your terminal manager to be manually enrolled.
To continue the CMS Online Enrollment process please click the button below to try again.
Before you begin, please ensure you have enough time to complete the enrollment process. It takes approximately 20 minutes. For security reasons if you exit before completing all steps,you will need to start the process from the beginning.