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

The Dial-A-Lift application is designed to help individuals with disabilities apply for paratransit services in High Point. This guide provides detailed steps to assist users in completing the application accurately and effectively.

Follow the steps to fill out the application correctly.

1. Press the ‘Get Form’ button to access the application online.
2. Begin by filling out Part A of the form. This section should be completed by the applicant or their representative. Provide your first name, middle initial, last name, address details, phone numbers, date of birth, gender, height, and weight accurately.
3. In case of an emergency, list two contacts who can be reached by Dial-A-Lift. Fill in their names, relationships, addresses, and contact numbers.
4. Answer the questions regarding your usage of the Hi tran fixed route bus system, along with detailed information regarding your disability or health condition and how it prevents you from utilizing the bus service.
5. Indicate any mobility aids you use and confirm if your home is equipped with a wheelchair ramp. These details are crucial for your eligibility assessment.
6. Specify whether you require a Personal Care Assistant when traveling and provide information about how far you can walk or travel independently.
7. Complete the section about how your disability affects various skills related to transportation. Provide specific explanations for each skill listed.
8. Once completed, review your application thoroughly to ensure that all sections are filled out accurately. Incomplete applications may be returned, causing delays.
9. Print and sign your application. If you are under 18 or unable to sign, a guardian or representative must sign on your behalf.
10. Part B of the application must be filled out and completed by a qualified professional familiar with your disability. The professional must provide their details and sign the verification form.
11. After both parts are filled out, compile the application and submit it either directly to the Dial-A-Lift office or return it to the professional for submission.
12. Be aware that the application will be processed within 21 days. You will receive a written notification regarding your eligibility.

Get started on your Dial-A-Lift application online today to secure your paratransit service.