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HEMPFIELD SCHOOL DISTRICT ALTERNATE CARE TRANSPORTATION REQUEST 20232024 Students may only use the assigned AM and PM stops. Different stop locations may not be used on different days (including early
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How to fill out alternate care transportation request

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How to fill out alternate care transportation request

01
Obtain the alternate care transportation request form from the designated department or agency.
02
Fill out the required personal information including name, address, contact number, and date of birth.
03
Provide details of the medical condition or special needs that require transportation services.
04
Indicate the date, time, and location of the appointment or medical facility to be visited.
05
Submit the completed form to the appropriate office or department for approval.

Who needs alternate care transportation request?

01
Individuals who are unable to drive themselves to medical appointments due to medical conditions or special needs.
02
Patients who require assistance getting to and from medical facilities for treatments or consultations.
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Alternate care transportation request is a form used to request transportation for individuals who require alternative care services.
Individuals or caretakers of individuals who are in need of transportation for alternative care services are required to file alternate care transportation request.
Alternate care transportation request can be filled out by providing personal information of the individual in need of transportation, details of the care services required, and any specific transportation preferences.
The purpose of alternate care transportation request is to ensure that individuals who require alternative care services have access to transportation to and from their care appointments.
Information such as the individual's name, contact information, medical condition, required care services, and preferred transportation mode must be reported on alternate care transportation request.
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