Get Repeat Trip Request Form - Hopelink

This guide provides step-by-step instructions on how to complete the Repeat Trip Request Form for Hopelink online. Following these instructions will help ensure that your transportation needs are met efficiently and accurately.

Follow the steps to successfully complete your request.

1. Click ‘Get Form’ button to obtain the form and open it in an appropriate editor.
2. Indicate the repeat start date by filling in the designated field. Ensure that you have the correct date for your appointments.
3. Enter today’s date in the corresponding section. This helps in tracking when the request was submitted.
4. Fill in the client name alongside the ProviderOne ID number, which can be the last name, first name, and middle initial. You may also substitute the date of birth if needed.
5. Describe your request in the comments section. Be clear whether you are requesting a new repeat appointment or changing an existing schedule.
6. Provide your phone number and determine if the client is able to travel independently. Choose 'YES' or 'NO' accordingly.
7. If the response is 'NO' regarding independent travel, ensure that arrangements for an attendant are noted, since drivers do not provide assistance beyond the main door.
8. Indicate whether the client uses a wheelchair or scooter and specify the size if applicable.
9. Note the total number of riders. Keep in mind that more than three may affect transportation resources.
10. Detail any other mobility aids or special needs the client may have in the provided section.
11. Determine if the client can use Metro’s Fixed Route Service for the appointment, marking 'YES' or 'NO'. If 'NO', ensure that the necessary documentation is on file.
12. Fill out the repeat schedule by selecting days and times for both the appointment and return trip.
13. Provide both the pickup and drop-off addresses, ensuring street address, city, zip code, and any specific entrance information is included.
14. State the medical reason for the appointment clearly to ensure coverage. Avoid vague terms and provide necessary details.
15. Confirm whether the service will be billed to medical coupons (Title 19) by selecting 'YES' or 'NO'.
16. Complete the request confirmation section and provide any additional comments or scheduled pickup/return times as needed.
17. Once all fields are completed, save changes, download the document, or print it for submission as required.

Complete your Repeat Trip Request Form online today to ensure your transportation needs are met.