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Palm Tran Paratransit Eligibility Application 2013 free printable template

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Para transit Eligibility Application www.palmtran.org Completed applications accepted via mail / fax / email or in person at: Palm Tran CONNECTION Community Transportation Coordinator 50 South Military
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How to fill out Palm Tran Paratransit Eligibility Application

01
Obtain the Palm Tran Paratransit Eligibility Application form online or at a designated Palm Tran location.
02
Fill out your personal information including name, address, phone number, and email.
03
Provide any necessary medical information that supports your eligibility for paratransit services.
04
Describe your specific mobility limitations or disabilities that prevent you from using regular public transportation.
05
Include information about your emergency contacts, if required.
06
Review the application for completeness and accuracy.
07
Sign and date the application to certify that the information provided is true.
08
Submit the application via mail, email, or in person to the designated Palm Tran office.

Who needs Palm Tran Paratransit Eligibility Application?

01
Individuals with disabilities that significantly limit their ability to use standard public transportation.
02
Elderly individuals who may have mobility challenges.
03
People recovering from temporary medical conditions that affect their mobility.
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Fares (exact change only — drivers do not carry cash) ADA ID: Ride free — call (561) 649-9838 to verify eligibility.
Palm Tran Connection is a shared ride, door-to-door paratransit service that provides transportation for disabled residents and visitors in Palm Beach County under the following programs: Americans with Disabilities Act (ADA)Program. Division of Senior Services (DOSS) Program Transportation Disadvantaged (TD) Program.
Connection and Go Glades riders, call customer service at (561) 649-9838 option #6 if you have left something behind. Monday thru Friday 8:00 a.m. to 4:30 p.m. Closed on holidays.
You must pre-register through Palm Tran Connection at 561-649-9838.
Palm Tran ParentPalm Beach CountyFounded1971 as (CoTran) later renamed as Palm TranHeadquartersWest Palm Beach, FloridaService typeBus, paratransitAllianceBroward County Transit, Tri-Rail, Amtrak, Martin County Transit11 more rows
Palm Tran Connection accepts credit cards for bus pass and tickets-to-ride purchases.

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The Palm Tran Paratransit Eligibility Application is a form used to determine an individual's eligibility for paratransit services provided by Palm Tran, which offers public transportation for those who are unable to use standard transit due to a disability or health condition.
Individuals who have disabilities or health conditions that prevent them from using traditional public transportation services are required to file the Palm Tran Paratransit Eligibility Application to access paratransit services.
To fill out the Palm Tran Paratransit Eligibility Application, applicants must complete the required sections providing personal information, details about their mobility limitations, and any documentation from healthcare providers if necessary.
The purpose of the Palm Tran Paratransit Eligibility Application is to assess and verify the eligibility of individuals for specialized paratransit services, ensuring that those who truly need assistance can access the transportation they require.
The information that must be reported on the Palm Tran Paratransit Eligibility Application includes the applicant's name, address, contact information, details about their disabilities or mobility limitations, and any supporting medical documentation as required.
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