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Medicine Hat TransitSpecial Transit Application Form The following 6 pages must be submitted IN FULL. Please PRINT legibility. TODAYS DATE:___ (Month / Day / Year) 1.APPLICANTS INFORMATION: First

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How to fill out special transit application form

01

Obtain a copy of the special transit application form from the transportation provider.

02

Fill out the personal information section including name, address, phone number, and date of birth.

03

Provide information on any mobility or cognitive impairments that necessitate the use of special transit services.

04

Indicate any additional support or accommodations that may be required during transportation.

05

Submit the completed application form to the transportation provider either in person or by mail.

Who needs special transit application form?

01

Individuals with mobility or cognitive impairments that prevent them from using regular public transportation services.

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What is special transit application form?

Special transit application form is a form used to request special transit services for individuals with disabilities or those who are unable to use regular public transportation.

Who is required to file special transit application form?

Individuals with disabilities or those who are unable to use regular public transportation are required to file special transit application form.

How to fill out special transit application form?

Special transit application form can be filled out by providing personal information, medical history, and details of the transportation needs.

What is the purpose of special transit application form?

The purpose of special transit application form is to ensure that individuals with disabilities or transportation limitations have access to necessary transportation services.

What information must be reported on special transit application form?

Information such as personal details, medical history, transportation needs, and any special requirements must be reported on special transit application form.

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