Get Bridges And Beyond Rutland Vt

Completing the Bridges And Beyond client application form is an essential step in accessing transportation services tailored to your needs. This guide will provide you with easy, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete your application.

1. Press the 'Get Form' button to access the application form and open it in your preferred digital setup.
2. Fill in the date of the application at the top of the form.
3. Complete the section asking how you learned about the Bridges & Beyond program.
4. Input your first name and last name in the designated fields.
5. Provide your date of birth, sex, and age in the respective sections.
6. Fill in your email address and residential address, including city, state, and zip code.
7. If your mailing address is different, provide that information in the appropriate section.
8. Enter your phone number and indicate if you allow messages to be left on your phone.
9. Repeat the same process for your cell phone number.
10. Provide directions to your home, ensuring clarity for transport services.
11. List your emergency contact's name, their relationship to you, and their phone number.
12. Indicate your Medicare and Medicaid status by selecting 'yes' or 'no' in the corresponding fields.
13. If applicable, detail any use of Medicaid transportation for medical appointments and any reasons for not using it.
14. Answer questions regarding smoking and the use of oxygen or mobility aids like walkers, canes, or wheelchairs.
15. Respond to questions about allergies or pets in your home.
16. If you have a disability, provide an explanation in the space given.
17. Indicate any mobility limitations regarding vehicle access.
18. Enter the number of passengers accompanying you to appointments and if they can assist if necessary.
19. Describe previous transportation methods and any available family or friends who can assist with transport.
20. Mention any past experiences with other volunteer transportation programs.
21. Specify the types of transportation services required: medical, shopping, or other, and detail specific upcoming transportation needs including date, destination, time, and expected duration.
22. Add any other relevant information that may assist the service provider.
23. Finally, sign the application and provide your name and phone number if you are not the applicant.
24. Once completed, make sure to save your changes, and download, print, or share the form as necessary.

Take the next step towards accessing transportation services by completing your application online today.