Yakima Transit Dial-A-Ride Eligibility Application
This document outlines the eligibility criteria and application process for Yakima Transit's Dial-A-Ride paratransit service. It is designed for individuals with disabilities who require assistance with public transportation. Complete the application to access door-to-door, shared-ride services tailored to your needs.
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How do I fill this out?
To fill out the Dial-A-Ride Eligibility Application, begin by providing your personal information clearly. Ensure all required sections are completed, as incomplete applications can lead to delays. Review the submission guidelines to ensure a smooth processing experience.

How to fill out the Yakima Transit Dial-A-Ride Eligibility Application?
1
Fill out Part 1 of the application completely.
2
Read and sign Part 2 as required.
3
Complete Part 3 with professional verification.
4
Return the application to the specified address on the form.
5
Ensure you have provided any additional requested information.
Who needs the Yakima Transit Dial-A-Ride Eligibility Application?
1
Individuals with mobility impairments who cannot use public transport.
2
People with cognitive disabilities requiring additional support.
3
Elderly residents needing assistance with transportation.
4
Individuals recovering from surgeries or medical procedures.
5
Those experiencing temporary disabilities or conditions affecting travel.
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What are the instructions for submitting this form?
To submit this form, ensure all parts are filled out completely and sign where required. Physical applications should be sent to the designated address on the form, while electronic submissions may be directed via email to the provided contact. For any questions about submission, contact customer support for clarification.
What are the important dates for this form in 2024 and 2025?
The Dial-A-Ride Eligibility Application was revised in January 2024. Important dates include reviewing qualifications annually and submitting applications as required for new or recertifying individuals.

What is the purpose of this form?
The purpose of this form is to assess eligibility for Yakima Transit's Dial-A-Ride paratransit service for individuals with disabilities. It ensures that those who require assistance can receive the proper transportation support needed for mobility. Moreover, it facilitates the provision of necessary resources and aids according to each applicant's unique situation.

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

- 1. Applicant's Name: Full name of the applicant as it appears on identification.
- 2. Pick-Up Address: Residential address where the applicant will be picked up.
- 3. Mailing Address: Address for correspondence, if different from the pick-up address.
- 4. Date of Birth: Optional information for identification purposes.
- 5. Disability Information: Details regarding the disabilities affecting mobility.
- 6. Emergency Contact: Contact information for an emergency person to reach.
- 7. Professional Verification: Section for licensed professionals to verify the applicant's condition.
What happens if I fail to submit this form?
If the form is not submitted correctly, you risk delays in receiving paratransit services. Incomplete or missing sections can result in your application being returned without processing.
- Delays in Service: Incomplete applications lead to delays in accessing transportation.
- Ineligibility: Failure to provide the necessary medical verification may result in ineligibility for the service.
- Required Resubmission: You may have to resubmit the application, prolonging the approval process.
How do I know when to use this form?

- 1. New Applicants: Individuals new to the service needing to establish eligibility.
- 2. Recertification: Current users of Dial-A-Ride that need to renew their eligibility status.
- 3. Service Changes: Those experiencing changes in condition that affects their transportation needs.
Frequently Asked Questions
Who can apply for the Dial-A-Ride service?
Individuals with disabilities that hinder their ability to use fixed route buses can apply.
What information do I need to provide?
You must provide personal details, a description of your disability, and a professional verification.
How do I submit the application?
You can submit the completed application by mail to the address listed on your form.
Is there a deadline for applications?
Applications should be submitted as soon as you are ready, but there are no specific deadlines.
Will I be notified after my application is processed?
Yes, you will receive a notification within 21 calendar days of receipt.
What if I need help filling out the application?
For assistance, you can call the provided contact number for support.
Can I access this application in other formats?
Yes, alternative formats are available upon request for individuals with disabilities.
Is verification from a professional always required?
Yes, Part 3 requires signature and verification from a licensed medical or mental health professional.
What if my application is incomplete?
If incomplete, your application will be returned, leading to delays.
Can I edit the application after downloading?
Yes, you can edit the PDF file using PrintFriendly's editing features after downloading.
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