Edit, Download, and Sign the MetroAccess Paratransit Application for Disabilities

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How do I fill this out?

Filling out this application requires careful attention to the instructions provided. Start by reading the application thoroughly and completing Part A. Be sure to gather the necessary documentation before proceeding to obtain your healthcare provider's certification.

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How to fill out the MetroAccess Paratransit Application for Disabilities?

  1. 1

    Read the application carefully and complete Part A.

  2. 2

    Review the included accessible transportation options document.

  3. 3

    Have a licensed healthcare provider complete Part B of the application.

  4. 4

    Conduct a pre-assessment interview by calling Metro Transit Accessibility Center.

  5. 5

    Bring your completed application to the scheduled appointment.

Who needs the MetroAccess Paratransit Application for Disabilities?

  1. 1

    Individuals with disabilities requiring transportation assistance.

  2. 2

    Healthcare providers certifying patients' disabilities for transportation.

  3. 3

    Caregivers or family members applying on behalf of someone with a disability.

  4. 4

    Senior citizens who may struggle with public transportation.

  5. 5

    People who have trouble using standard Metro services due to mobility issues.

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What are the instructions for submitting this form?

To submit this form, please ensure it is completely filled out, including healthcare provider certification. Deliver the application in person to the Metro Transit Accessibility Center at 655 Virginia Avenue, SW, Washington, DC 20024, or contact them at (202) 962-2700. Ensure that applications are submitted within the 60-day limit from the date of the healthcare provider's signature; otherwise, they will not be accepted.

What are the important dates for this form in 2024 and 2025?

Check the application submission deadlines for 2024 and 2025 to ensure on-time processing. Applications should be completed promptly to allow sufficient time for assessments and eligibility verification. Important dates vary depending on service changes, so staying informed is essential.

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What is the purpose of this form?

The purpose of this form is to facilitate access to the MetroAccess Door-to-Door Paratransit service for individuals with disabilities. It ensures that eligible persons can easily apply for necessary transportation assistance. By collecting relevant information and certifications, the form helps Metro determine qualifications and needs for services.

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Tell me about this form and its components and fields line-by-line.

The application consists of several key fields that collect personal information, health details, and eligibility affirmations.
fields
  • 1. Last Name: The individual's last name.
  • 2. First Name: The individual's first name.
  • 3. Middle Initial: The individual's middle initial, if applicable.
  • 4. Street Address: The current residential address of the applicant.
  • 5. Apartment Number: The apartment number, if applicable.
  • 6. City: The city of residence.
  • 7. State: The state of residence.
  • 8. Zip Code: The postal code for the address.
  • 9. County: The county of residence.
  • 10. Gender: The gender of the applicant.
  • 11. Date of Birth: The birthdate of the individual.
  • 12. Primary Phone: The main contact number for the applicant.
  • 13. Email: An email address for correspondence.
  • 14. Emergency Contact Name: Name of an individual to contact in case of emergency.
  • 15. Emergency Contact Relationship: Relationship of the emergency contact to the applicant.
  • 16. Emergency Contact Phone: Phone number for the emergency contact.
  • 17. Mobility Devices: Information regarding mobility devices used by the applicant.

What happens if I fail to submit this form?

Failure to submit this form can result in delays or ineligibility for MetroAccess services. Accurate completion is essential to ensure timely processing and assessments.

  • Incomplete Information: If any required fields are missing, the application will be returned for corrections.
  • Missing Healthcare Provider Certification: Without necessary certifications from a healthcare provider, your application cannot be processed.
  • Late Submission: Submitting the application after the 60-day window may lead to it being rejected.

How do I know when to use this form?

This form should be used when individuals with disabilities need to apply for MetroAccess services. It is applicable when accessible public transportation options are not viable due to specific disability-related limitations.
fields
  • 1. For New Applicants: Individuals who have not previously applied for MetroAccess services.
  • 2. For Current MetroAccess Users: Current users who need to update their information or reapply after a lapse.
  • 3. Families Applying for Dependents: Parents or guardians filling out the application for minors or dependents.

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