Get Ca Raba Demand Response Eligibility Application 2019-2025

The CA RABA Demand Response Eligibility Application is designed for individuals who are functionally unable to use the RABA Fixed Route Bus Service due to disabilities. This guide will provide you with clear, step-by-step instructions for completing the application online in a straightforward manner.

Follow the steps to complete the application accurately.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Complete the Demand Response Applicant Form (green). Provide your personal and contact information, including your name, date of birth, and daytime phone number. Ensure you indicate any need for a personal care attendant and sign and date Page 5.
3. Fill out the section titled 'Tell Us About Your Disability,' providing detailed responses about how your disability affects your ability to use the Fixed Route Bus Service. Include information regarding any mobility aids or specialized equipment you use.
4. Answer questions regarding your living situation and travel capabilities. Be specific about how far you can walk and any assistance you may require when waiting for transportation.
5. Once completed, proceed to the Certification section and review your answers carefully. Sign and date the certification to verify that the information is true and correct.
6. Complete the Authorization Form for Disclosure of Protected Health Information. Indicate whether you authorize the disclosure and provide it to your physician if you consent.
7. If applicable, have your physician complete the Demand Response Physician Verification Form. Ensure they return it to RABA along with the signed authorization form.
8. Submit your completed application to RABA by mail, in person, or by fax as outlined in the instructions. Make sure all required forms are included.
9. After submission, wait for RABA to review your application. You can use Demand Response Service during this waiting period.
10. Upon receiving your eligibility determination letter, ensure to keep the document for your records and follow any additional instructions provided.
11. Remember to save any changes you make, and you have the option to download, print, or share the application as needed.

Begin the application process now and ensure your access to essential transportation services.