Get Application For Discount Id - City Of Durham - Durhamnc

Filling out the APPLICATION FOR DISCOUNT ID from the City of Durham can seem daunting, but with this guide, you will navigate the process seamlessly. This step-by-step instruction will help you complete the form accurately, ensuring that you can access the necessary services for your transportation needs.

Follow the steps to successfully complete your application.

1. Click 'Get Form' button to access the application form and open it in your preferred document editor.
2. Begin by providing your personal information. Fill in your name, address, city, zip code, and home phone number in the designated fields.
3. Enter your date of birth in the specified format. This helps verify your eligibility based on age.
4. In the authorization section, indicate your consent for the health care professional to release your protected health information. Ensure you understand the expiration of this authorization and your rights regarding it.
5. Sign the application in the provided space, and if you are under 18 years old, include the signature of your parent or guardian.
6. Next, your licensed or certified health care professional must complete the section regarding your transportation needs. They should indicate any required special facilities and whether an aide is needed.
7. Ask your health care professional to classify your disability as permanent, long term, or temporary, and specify the expected duration if it is temporary.
8. Lastly, ensure your health care professional provides their signature and includes your diagnosis or relevant ICD codes on the back of the form.
9. Once the form is filled out, review your application for completeness, then save your changes. You can choose to download, print, or share the completed form as needed.

Complete your APPLICATION FOR DISCOUNT ID online today and take the first step towards accessing essential transportation services.