Get Care-a-van Application - Carta - Gocarta

The Care-A-Van Application - Carta - Gocarta is an important document for individuals with disabilities seeking accessible transportation services. This guide provides straightforward steps to assist users in completing the application accurately and efficiently online.

Follow the steps to successfully complete your application.

1. Click the 'Get Form' button to obtain the Care-A-Van application form and open it in your preferred document editor.
2. Begin by filling out the personal information section. Enter the date of the application, social security number, and print your full name clearly. Specify your gender and provide your address, including apartment number (if applicable), city, state, zip code, and telephone numbers for home and work.
3. Provide your birth date and email address, and complete the emergency contact information. This section is mandatory; failure to fill it out will result in the application being returned.
4. In the disability section, list your specific diagnosis clearly and check any applicable mobility aids. Answer all questions, ensuring you do not leave any field blank. Specify if your condition is temporary and the expected duration.
5. Indicate if you use any mobility aids and provide details about their size if they are larger than standard dimensions. Respond to questions about your need for assistance while traveling.
6. Answer all questions regarding your physical capabilities, ensuring to indicate whether you can walk certain distances without assistance.
7. Explain how your disabilities prevent you from using a regular CARTA bus. Include any additional illnesses or disabilities that may be pertinent to your application.
8. Specify who will be responsible for payment for services, and refill the details if applicable. Acknowledge that your information may be shared with emergency services.
9. Complete the medical authorization section, including the name and contact information of a medical professional familiar with your disability. Ensure this section is signed.
10. If someone else completed the application on your behalf, that individual must fill out their contact information fully.
11. Once all sections are completed, review the application for accuracy. Save your changes, and download or print the form. Lastly, submit it to the specified address: CARTA Care-A-Van, 1617 Wilcox Boulevard, Chattanooga, TN 37406.

Begin filling out your Care-A-Van application online today to ensure your transportation needs are met.