Get Dial-a-lift Application By Age - Highpointnc.gov - Highpointnc

The Dial-A-Lift application provides an essential transportation service for elderly individuals residing in High Point. This guide will help you navigate through the online application process to ensure you complete it accurately and efficiently.

Follow the steps to complete your application online.

1. Press the ‘Get Form’ button to access the application and open it in your chosen editing tool.
2. In the application form, start by entering your personal information accurately. Fill in your name, address, and any applicable apartment number.
3. Include your city, state, and ZIP code to ensure proper location information is provided.
4. If your mailing address differs from your physical address, please enter it in the specified section.
5. Next, provide your phone number and date of birth. Ensure that your birthdate reflects your age of 60 or older.
6. Specify your height and weight in the corresponding fields.
7. Fill out the emergency contact information by providing the name, relationship, and phone number of someone who can be reached in case of an emergency.
8. In the 'Elderly Certification' section, confirm your eligibility by checking the yes or no boxes regarding health conditions and mobility needs.
9. Indicate whether you require a wheelchair, and if so, provide the size and weight of the wheelchair.
10. List any mobility aids or equipment you may use, such as a cane or walker.
11. If you require a private escort for travel, specify your needs and confirm the necessity.
12. Provide any additional special assistance that you may need during your travels.
13. At the end of the form, verify that all your provided information is complete and accurate. Sign and date the application.
14. Finally, prepare to send copies of required documentation that verify your birthdate. Avoid sending original documents.
15. Once you have completed the form, submit it as instructed, and allow the Dial-A-Lift office up to 21 business days to process your application and notify you of your approval status.

Complete your Dial-A-Lift application online today for accessible transportation services.