Go COMO Paratransit Application . Ensure the applicant or, if applicable, Legal Guardian or Power of Attorney (POA) signs the application form on page 4. Please choose only one form … Many people with disabilities can use C TRAN’s regular lift … Paratransit Eligibility Application 419 Bradley Dr. ∙PO Box 11286 ∙ Lynchburg, VA 24506 Phone: 434-455-5080 ∙Fax: 434-616-3138 Form II: Health Care Professional Verification To be completed by a physician or an approved health care professional only. Applications are available in regular or large print English, regular print Spanish, in Braille or on audiotape. Your Florida licensed healthcare provider most familiar with your disabling condition(s) is to complete and sign the Medical … Uncompleted forms will be discarded. Part II-Application (Professional Verification) 4. To receive an application, call RT at (916) 557-4685 or (916) 557-4686 TDD; or email paratransit@sacrt.com; or download the ADA Paratransit Interactive Application by visiting this link, and scrolling down to the “ADA Paratransit … Information about your disability which you provide in the application will be kept strictly confidential. Application for Paratransit Transportation Services (MATP, Persons with Disabilities (PwD), ADA, Senior Shared Ride - 60-64 and 65+, Public Full Fare) 1. Paratransit Fare. Access to mainline, fixed route transportation services is the main goal of the transportation provisions of the ADA. Although Paratransit attempts to minimize travel time, passengers may ride for up to 75 minutes. Enclosed is an application packet including: 1. This part of the application is for paratransit (van) services Paratransit Service for ADA Visitors. If an eligible ParaTransit rider should find he or she needs a personal care attendant after approval of the original application, the rider must notify the Office for People with Disabilities in writing. Please complete this application as thoroughly as possible and to the best of your ability. Since 1990, the Americans with Disabilities Act (ADA) has required all public transit agencies to provide paratransit services to eligible … ACCESS LYNX ELIGIBILITY APPLICATION FOR PARATRANSIT SERVICES . Please fill out the application completely, sign all the pages requiring your signature and return it to us by mail. Customers can now use mobile ticketing to purchase four types of fare media -- Paratransit 1-Ride Card, Paratransit All-Day, Paratransit 7-Day and Paratransit Monthly Passes. Last Updated: Tue, 14-May-2019, 12:38:50 PM, EDT For general Paratransit information or information in an alternate form, call the HRT Paratransit office directly at (757) 222-6087. Return this application to: BJCTA-MAX Post Office Box 10212 Birmingham, Alabama 35202-0212 Email:ada@bjcta.org Fax: (205) 521-0182. I understand that any false information or omission may lead to termination of my transportation privileges on the ADA Paratransit vehicles. San Francisco Paratransit (“SF Paratransit”) is a van and taxi program for people unable to independently use or access public transit because of a disability or disabling health condition. All information that you supply will be kept strictly confidential. If there are questions that you cannot answer, or if you need assistance to complete this form, please call Paratransit Customer Service at 573-874-7290. The Paratransit Riders Choice program is a pilot program for existing paratransit customers. Please fill out this form completely. East Bay Paratransit Application Download . Key changes that took effect Jan. 1, 2018. NFTA Special Services/Paratransit 181 Ellicott Street Buffalo, New York 14203 Dear Applicant, Thank you for your interest in the NFTA-Metro paratransit service for people with disabilities. A complete Paratransit application includes the application form, authorization form completed by the applicant, and a professional verification form completed by the professional authorized to verify the applicant's information. A personal care attendant traveling with a rider does not pay a fare. A second level assessment could include a telephone interview with you, medical verification, or an in-person interview. If Rockford ParaTransit denies the application, the individual shall be given the opportunity to file an appeal. Return form and verification documents to Paratransit Services. Address provided Updated: Tue, 14-May-2019, 12:38:50 PM, EDT packages are not factors... 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