Please select a future service date. Service dates cannot be in the past.
Our office hours are from 7:00 AM to 10:00 PM, so rides must be scheduled within these hours.
Weekend Rides: If your selected date falls on a Saturday or Sunday, the weekend rate will apply.
Same-day bookings are accepted but must be scheduled at least 2 hours in advance to ensure availability and timely service. If the desired pickup time is less than 2 hours from now, please choose a later time or another date.
2. Pickup Time:
Pickup times must be within our operating hours of 7:00 AM to 10:00 PM.
For same-day rides, ensure the pickup time is scheduled at least 2 hours ahead of the current time to allow for preparation and coordination.
After-Hours Rides: If your pickup time is after 5:00 PM, an after-hours rate will apply.
By following these guidelines, we can ensure prompt and reliable service for your transportation needs.
Service Type:
Overview: This is a basic transport service for clients who can walk independently.
Pickup Date:
Time:
Service Notes:
Address
Selecting Your Pickup and Drop-Off Locations:
1. Pickup Location:
Enter the exact address where you need to be picked up. This could be your home, a hospital, a clinic, or any other medical facility.
Ensure the address is correct and specific, including any necessary details like the building name, suite number, or entrance to avoid confusion
2. Drop-Off Location:
Enter the precise address or name of the location where you need to be dropped off, such as a hospital, clinic, rehabilitation center, or your home. If the drop-off is at a large facility, include the building name, wing, or unit number to ensure accurate drop-off.
If the drop-off location has specific access points or preferred entrances (e.g., emergency entrance, patient discharge area, or a side door with ramp access), please provide these details when booking to ensure a smooth drop-off process.
If you will need help upon arrival, such as getting into a building, navigating stairs, or assistance with mobility (e.g., wheelchair or walker), include these instructions so our driver can be prepared to assist.
If this is part of a round trip, make sure you have selected a return time and location. You can also schedule a pickup from a different location after your medical appointment.
3. Trip Type: One-Way or Round Trip:
a. One-Way Trip:
If you only need transportation to the drop-off location, select the "One-Way" option.
You will only need to provide the pickup and drop-off locations along with your desired pickup time.
b. Round Trip:
If you need transportation to your destination and back, select the "Round Trip" option.
After choosing "Round Trip," you will be prompted to:
Select Return Time: Indicate the time you'd like to be picked up for your return trip.
Select Return Date: Choose the date for your return trip. If the return date is not on the same day as your initial trip, additional charges for long-distance travel will apply, which may include fees for hotel, food, and wait time for the driver.
Select Return Location: Specify where you would like to be picked up for the return leg of your trip. This could be the same as your drop-off location or a different one.
4. Additional Notes:
For round trips, it’s important to provide accurate return information to ensure smooth and timely service.
If you need to make changes to any part of your trip (pickup, drop-off, or return details), please inform us as soon as possible.
Ensure all locations are accessible and safe for both pickup and drop-off.
Return Date:
Time:
Return Location
Location Notes:
Client Details
Please enter the client's information below so we can stay in touch regarding transportation services.
Billing
Would you like to use Direct Pay (Out-of-Pocket) or Insurance Coverage for your transportation services?
To ensure accurate billing, could you please let us know if you are the client, a family member, or a third-party provider responsible for payment?
I'm a...
Please enter the billing contact information below so we can stay in touch regarding payment.
Please enter the name of your insurance provider:
To expedite the process, please securely upload a copy of your insurance card below.