Get Laketran Ada Dial-a-ride Application

This guide provides step-by-step instructions for completing the Laketran ADA Dial-a-Ride Application online. By following these instructions, users can efficiently fill out the application to apply for eligibility for the ADA Dial-a-Ride Program.

Follow the steps to complete your application online

1. Press the ‘Get Form’ button to access the application and open it in the editor.
2. Fill out Part I, which includes your personal background information such as name, address, and date of birth. Ensure all fields are completed thoroughly.
3. In Part II, provide detailed information about your disability or disabilities. Answer questions regarding your ability to use the local route bus service and any mobility aids you utilize.
4. Complete Part III by checking applicable boxes that describe your current use of the local route bus service. Be specific about your experiences and challenges.
5. In Part IV, describe your current travel situation and the terrain in your neighborhood. List frequently visited destinations and the methods of travel you currently use.
6. Complete Part V with your certification information. Sign and date the application, confirming that all information provided is accurate.
7. If someone assisted you in filling out the form, complete Part VI with their information.
8. In Part VII, authorize your healthcare professional to provide relevant medical information regarding your condition. Ensure to include their contact details.
9. Finally, have your healthcare professional complete Part VIII to certify your disability and its impact on using the bus service. They must sign and date this section.
10. Once all parts of the application are complete, save your changes and download the form. You can then print and mail the completed application to Laketran's ADA Coordinator at the provided address.

Begin your application today by filling out the Laketran ADA Dial-a-Ride Application online.