Get Application For Paratransit Services - Lakecountyfl

This guide will help users navigate the Application For Paratransit Services from Lake County, providing step-by-step instructions for filling out the form online. Whether you are applying for transportation disadvantaged services or ADA assistance, this guide ensures you understand each component required for your application.

Follow the steps to complete your application smoothly and accurately.

1. Click ‘Get Form’ button to obtain the application and open it in your preferred PDF editor.
2. Begin by entering your personal details, including the last name, first name, middle initial, and date of birth. Ensure all information is accurate.
3. Select the program you are applying for by checking the appropriate boxes: Transportation Disadvantaged, ADA, or both.
4. Complete the medical verification section if you are applying for ADA. This section must be signed by an approved health care professional, unless a functional assessment is conducted.
5. Fill out your home address including apartment or lot number, city, county, state, and zip code. If you live in a gated community, provide the gate code.
6. Provide contact information including home phone, work phone, cell phone, and email address.
7. If applicable, complete the emergency contact section by providing names, relationships, and phone numbers for primary and secondary contacts.
8. Indicate any mobility devices or assistance you require by checking all that apply, such as portable oxygen, service animal, or stretcher.
9. Answer questions regarding your current travel methods, including how you generally reach your destination.
10. Complete the functional ability section, indicating whether you can perform basic tasks without assistance.
11. Certify your application by reading the acknowledgment, then sign and date the application. If someone is signing on your behalf, provide their relationship to you.
12. If applying for the ADA program, ensure that the medical professional section is filled out, signed, and dated.
13. Review the completed application for accuracy. Once satisfied, save the document and consider downloading or printing a copy for your records before submitting it.
14. Return the completed form to Lake County Connection by mail or via the provided contact methods listed on the form.

Complete your application online today and take the first step towards accessing essential paratransit services.