Get Proline Application9-2014 - Websitepdf - Stark Area Regional

Completing the Proline application is essential for individuals seeking Paratransit services due to disabilities. This guide provides clear instructions on filling out the application accurately and efficiently.

Follow the steps to complete your application online.

1. Click ‘Get Form’ button to obtain the form and open it for your use.
2. Begin by entering your personal information, including your first name, middle initial, last name, and contact details such as home phone, cell phone, and email address. Ensure accuracy as this information will be used for communication regarding your application.
3. Indicate your preference for receiving notifications about your application, such as reminders or imminent arrival notices by selecting your choice of text, phone, or email.
4. Provide your home address, including street address, city, ZIP code, and any specific details such as apartment name and number if applicable. If your mailing address differs from your home address, fill out the additional mailing address section.
5. Complete the emergency contact section by providing the first name and last name of an individual who can be reached in case of emergencies, along with their phone number.
6. Fill out the applicant's release section. Here, you will acknowledge the purpose of the evaluation form and affirm the confidentiality of the information provided, along with your signature and date.
7. Answer the series of questions regarding your health condition or disability and its impact on your ability to use the fixed route bus services. This includes providing information about mobility aids, assistance requirements, and the effects of weather on your travel.
8. Complete the medical verification form by having a licensed physician provide the necessary information about your condition. This form is critical, and both the ADA Paratransit application and the medical verification must be submitted together.
9. Once you have filled out both forms, ensure all information is complete and accurate. Then, save your changes if you're using a digital format, or print the forms for submission.
10. Mail the original application and medical verification form to the designated address: Stark Area Regional Transit Authority, ADA Paratransit Services, 1600 Gateway Blvd., SE, Canton, OH 44707. Faxes and copied forms will not be accepted.

Start filling out your Proline application online today to access the necessary Paratransit services.