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Take Me Home, West Virginia 24 Hour Emergency Backup Plan Version 5.2 PARTICIPANT INFORMATION Last Name Medicaid No. First Name Date of Birth Transition Date Address Street City Zip State County REQUIRED
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Take Me Home West is a program designed to provide safe transportation for individuals who are unable to drive and need assistance getting home.
Individuals or organizations responsible for coordinating transportation services for those in need are required to file Take Me Home West.
Take Me Home West can be filled out by providing details on the individual in need of transportation, their location, contact information, and any special instructions for the service provider.
The purpose of Take Me Home West is to ensure that individuals who are unable to drive have a safe and reliable means of transportation to get home.
Information such as the individual's name, location, contact information, any special needs or instructions, and the preferred method of transportation must be reported on Take Me Home West.
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