Get Ca Ada Paratransit Service Eligibility Application - City Of Petaluma 2022-2025

This guide provides clear and supportive instructions on how to complete the CA ADA Paratransit Service Eligibility Application. Whether you are applying for yourself or a person you support, this step-by-step approach ensures that you have the necessary information and guidance.

Follow the steps to successfully complete your application online.

1. Use the ‘Get Form’ button to access the CA ADA Paratransit Service Eligibility Application, making sure you have it open on your screen for filling out.
2. Begin by providing your applicant information. Indicate whether this is a new application or a recertification. Fill in your full name, birthdate, and gender, as well as your primary language preference.
3. Complete your service address and any different mailing address, if applicable. Ensure you enter both your daytime and evening phone numbers, along with your email address.
4. In case of an emergency, provide the contact information for a preferred individual, ensuring you include their relationship to you.
5. Answer the questions regarding your disability or health-related condition in detail. This includes describing how your condition affects your ability to use public transit.
6. Indicate the types of disabilities you have and whether they are permanent, temporary, or unknown. Provide additional context if required.
7. Address questions about your current use of fixed-route bus service, including last usage, training received, and ability to wait for a bus.
8. Detail your mobility aids and equipment. Select all that apply and provide any additional relevant information.
9. Complete the Applicant Certification section by providing your signature and date. Ensure you understand the implications of your certification.
10. If applicable, fill out the Authorization to Release Medical Information section, including the name and contact information of the licensed professional who can verify your disability.
11. After ensuring all sections are complete, either print or download the form. You should keep a copy for your records.
12. Submit your completed application via the designated channels (email or mail) according to your service address.

Begin your application process online today to access important paratransit services.