The application must be complete before it will be reviewed; a complete Paratransit Eligibility application is defined by: 1) all questions within the application are answered to the best of the applicant’s ability, 2) the application is signed by the applicant or the individual completing the application, (i.e. The City of Fargo's Health Officer, an M.D., will advise the Committee as necessary. In operation, eligibility will be based on whether the MATBUS Fixed Route System can provide its service to the particular individual for a particular trip. Anyone who utilizes MAT Paratransit more than 21 days in any 365-day period may be required to apply for eligibility. I certify that the information provided in the application is true and correct. • I.D. Fargo, ND 58102 The medical information that may be gathered as part of the eligibility determination process will not be shared with any other party. If the applicant is considered eligible but only under certain conditions, the reservationist will review each trip requested to see if that trip meets the conditions that were established when eligibility was determined. You will be asked to provide the name of a medical or qualified social service professional who can verify your disability. A subcommittee of the Metro Area Mayors’ Committee for People with Disabilities (Appeals Subcommittee) will serve as the Administrative Appeals Board for the Cities of Fargo and Moorhead. Once approved, you will receive a Rider ID Card which indicates you are eligible for MAT Paratransit. Written appeals shall be delivered to MAT Paratransit, Transit Administration Office, 650 23rd Street North, Fargo, ND 58102 for consideration. Completing this pre-application is the first step in determining the right public transportation service for you. • Expiration date if any for eligibility Revisions: 5/7/14, 8/8/16 Page 1 . THIS APPLICATION WILL BE ACCEPTED AT ANY ADA PARATRANSIT PROVIDER IN THE STATE OF CONNECTICUT. Apply for Paratransit Service To apply or recertify for Hampton Roads Transit Paratransit services, call ADARIDE toll free at (877) ADA-RIDE (1-877-232-7433) and request an application by mail. Flexibility is at your fingertips with rabbittransit’s on-demand shuttle. To be eligible for paratransit, you must be unable to use Muni’s accessible buses, trains, or streetcars some or all of the time, without the aid of another person. (701) 241-8140 To receive an application by mail, call 1-800-632-9063. If the applicant is considered eligible but only under certain conditions, the reservationist will review each trip requested to see if that trip meets the conditions that were established when eligibility was determined. Any limitation/condition placed upon a certification by another community will be observed by MAT Paratransit to the extent possible. All MAT Paratransit riders are issued a Rider ID Card once approved for the service. • Telephone number to call to reserve a ride e. Eligible individuals must renew or recertify eligibility every three years, except in cases of temporary eligibility. MATBUS I hereby certify that, to the best of my knowledge, information given in this application is correct. Return this application to: BJCTA-MAX Post Office Box 10212 Birmingham, Alabama 35202-0212 Be unable to get to and from a bus stop or on and off a lift-equipped bus by yourself 2. d. A written determination of the decision on the appeal, including the reasons for such decision, shall be forwarded to the applicant within 30 days of the completion of the appeals process. Visitors who are certified by another city will be presumed eligible for a period of 21 days. • Expiration date for eligibility A photo of the passenger is required for the card. However, all riders must pre-register for Paratransit Service before requesting a trip. If the applicant wishes to appeal the eligibility determination, the following process shall be followed: a. An individual will be certified as ADA Paratransit Eligible if there is any part of the MATBUS Fixed Route System in the designated service area which cannot be used or navigated by that individual because of a disability (refer to Section 3.2 - Definition of Disabled Individual). A person traveling with a friend or attendant is still eligible for paratransit service even if they would be able to use the Fixed Route System with this other person's help. d. Eligible individuals will be issued a Special User Card and/or letter stating they are eligible for MAT Paratransit and whether or not they are also "ADA Paratransit Eligible." • Telephone number to call to reserve a ride What's New. 3.6 Eligibility Appeals Process [Federal Regulation 49 CFR 37.125(g)]. An incomplete application will be returned. A subcommittee of the Metro Area Mayors’ Committee for People with Disabilities (Appeals Subcommittee) will serve as the Administrative Appeals Board for the Cities of Fargo and Moorhead. To pre-register, riders must complete an application to identify which program they will qualify for to assist with funding. All applications must be verified by a physician, licensed health care professional, or rehabilitation professional. The MATBUS Mobility Manager is responsible for reviewing applications and determining eligibility. An individual may appeal a denied trip in the same manner as they appeal a denial of eligibility (refer to Section 3.6 - Eligibility Appeals Process). If you have any questions regarding the completion of this application, please call June Slaughter, Paratransit Manager, at (478) 803-2521. A final determination of eligibility will be within 21 days of receiving the application form, authorization form and professional verification form. The Committee consists of four members of the full committee and one Paratransit rider. You may also submit them via U.S. mail or by fax via the information listed below. Department of Health Face Covering Order STA to Enforce Department of Health Face Covering Order - Stringent Safety and Sanitation … Real Time Information is Here! I understand that falsification of information may result in denial of service. Following receipt of a completed application and professional verification, processing of the application may take up to three weeks. MATBUS sends the verification form to the professional identified by the applicant on the authorization form. 650 23rd Street North Since 1990, the Americans with Disabilities Act (ADA) has required all public transit agencies to provide paratransit services to eligible disabled people. • Any conditions or limitations that apply to the Individual's eligibility cards will be required to use this service. However, all riders must pre-register for Paratransit Service before requesting a trip. ADA Paratransit Service: A type of public transit service required to be provided according to ADA federal regulations. Determination of ineligibility will include reasons for the finding and inform the applicant of the appeals process. Conditions are identified in the eligibility letter and noted on the Rider ID Card. Phone Numbers: Main Phone Number (510) 287-5000 Toll Free 1-800-555-8085 . If a decision is not made within 30 days, the applicant will be determined temporarily eligible until such time as the decision regarding the appeal is made by the Committee. 3.2 Definition of Disabled Individual [Federal Regulation 49 CFR '37.3]. APPLICATION FOR PARATRANSIT SERVICE . The RTA ADA Paratransit Certification Program determines an individual's functional abilities and limitations for using fixed route services. If a determination is not made within 21 days, the applicant will be determined temporarily eligible until such time as the final determination of eligibility is made by the Mobility Manager. This documentation shall include the following: • Name of eligible individual "Any individual with a disability who needs the assistance of a wheelchair lift or other boarding assistance device and is able, with such assistance, to board, ride, and disembark from any vehicle which is readily accessible to and usable by individuals with disabilities if the individual wants to travel on a route of the system during the hours of operation of the system at a time, or within a reasonable period of such time, when such a vehicle is not being used to provide designated public transportation on the route.". Included in this category are individuals with mental or visual impairments who cannot use or "navigate the system." All applications must be completed in their entirety or they will be returned to the applicant for completion before being processed. The Special User Card issued by MATBUS entitles an individual to ride the Fixed Route Bus System (MATBUS) for discount fare, which is $0.75 cash (half the cash fare paid by an adult of $1.50). • Name of transit provider, MAT Paratransit This documentation shall include the following: • Name of eligible individual CATEGORY 2: ABLE TO BOARD, RIDE AND DISEMBARK ONLY IF THE VEHICLE IS ACCESSIBLE (EQUIPPED WITH BOARDING DEVICE SUCH AS A LIFT). Home » Services » Para-Transit Services Go COMO fares are currently suspended for both fixed route and para-transit rides. However, an exceptional trip (to a restaurant, for example) would be ADA eligible. A complete Paratransit application includes the application form, authorization form completed by the applicant, and a professional verification form completed by the professional authorized to verify the applicant's information. You can request a free application for this card from Metro Area Transit or download it as a PDF. There are a number of options available for new riders to provide a picture including providing a hardcopy or emailing a photo upon application, or once approved the driver can take a picture and a Rider ID Card. Under the ADA, transit agencies operating a fixedroute system must provide a comparable - paratransit system for people with disabilities who cannot use the fixedroute system. Submit your change of address form here, Columbia and Montour Veterans Transportation, Transportation Partnership on Mobility (TPOM). To pre-register, riders must complete an application to identify which program they will qualify for to assist with funding. Applications are available at www.matbus.com, Ground Transportation Center (GTC), 502 NP Avenue, Fargo and Metro Transit Garage, 650 23rd St. N., Fargo. A person is eligible for paratransit service if the fixed route on which they want to travel is not yet accessible. b. If service is needed beyond 21 days, the individual is required to apply for eligibility by the Cities of Fargo or Moorhead. A written determination of the decision on the appeal, including the reasons for such decision, shall be forwarded to the applicant within 30 days of the completion of the appeals process. All Para-Transit riders must complete an application certifying their Para-Transit eligibility. Refer to Section 3.5 - Eligibility Process to apply for a Special User Card. People with disabilities who are certified as “ADA Paratransit Eligible” may ride MAT Paratransit. Have a cognitive disability that prohibits your understanding of how to complete bus trips As part of the certification process, you must complete an application and provide a licensed medical professional's statement to verify your disability. If the applicant wishes to appeal the eligibility determination, the following process shall be followed: a. Under this category, the "specific impairment-related condition" must prevent the person from using the fixed route system. Proof of age is required to apply. You must complete an application form that you can obtain by: Downloading the application form Picking up a form at either of our office locations Contact our Brokerage Office at 519-451-1340 ext 381 and leave a message with your name and address Application for Paratransit Transportation Services (MATP, Persons with Disabilities (PwD), ADA, Senior Shared Ride - 60-64 and 65+, Public Full Fare) 1. UTA's Paratransit Service ADA program is a service of the Utah Transit Authority, for people with physical, cognitive or visual disabilities who are functionally unable to independently use the UTA fixed route bus service either all of the time, temporarily or only under certain circumstances. a. Paratransit is shared ride public transportation, complementary to fixed route transit service. To travel on Marin Access Paratransit, you must meet one of the following criteria: 1. A determination of eligibility will occur within 21 days of receiving the application form, authorization form, and professional verification form. Written appeals shall be delivered to MAT Paratransit, Transit Administration Office, 650 23rd Street North, Fargo, ND 58102 for consideration. Visitors who have not been certified as eligible by another public entity but claim that they are "ADA Paratransit Eligible" will be assumed eligible for up to 21 days during any 365-day period. Upon completion of the application, you must must schedule an interview with the Office for People with Disabilities to review your application. Additional information is included in the application. VTA ACCESS paratransit service is provided to eligible individuals with disabilities who cannot use conventional accessible bus and light rail transit service due to their physical, visual or cognitive disabilities. 3.4 Eligibility of Visitors [Federal Regulation 49 CFR '37.127], 3.5 Eligibility Process (Federal Regulation 49 CFR '37.125). Paratransit Fare. City of Columbia Official Coronavirus (COVID-19) information . If you are determined by the Cities of Fargo or Moorhead to be "ADA Paratransit Eligible" that eligibility entitles you to utilize paratransit services in other communities that you might visit throughout the nation for up to 21 days in a 365-day period. You will need to print the form to have Part B completed by your health care professional. It will not be provided to any outside person or agency. A complete Paratransit application includes the application form, authorization form completed by the applicant, and a professional verification form completed by the professional authorized to verify the applicant's information. • Initial date for eligibility The acceptable proofs of age include: Birth Certificate, Baptismal Certificate, Driver’s License, PACE Card, State ID, Armed Forces Discharge/Separation Papers, Passport or Naturalization Papers, Veteran’s Universal Access ID Card, Statement of Age from the Social Security Administration, or Resident Alien Card. Americans with Disabilities Act (ADA): Civil Rights act passed by the U.S. Congress in 1990, which mandates equal opportunities for people with disabilities in the areas of employment, transportation, communications and public accommodations. ADA Paratransit Eligibility is based on a functional, rather than medical, model. • Whether the eligible individual utilizes a personal care attendant Pennsylvania counties have varying Paratransit services available for their residents. All applicants must qualify for certification under the guidelines established by the Americans with Disa… Application for ADA Paratransit Eligibility Please complete ALL sections of this form. MATBUS sends the verification form to the professional identified by the applicant on the authorization form. • An individual is eligible if they use a "common wheelchair" but cannot be served by the fixed route system because the lift on the vehicle they need to use does not meet the federal equipment standards. • A person is eligible if the bus route on which they want to travel is not 100% accessible. d. A written determination of the decision on the appeal, including the reasons for such decision, shall be forwarded to the applicant within 30 days of the completion of the appeals process. • Name of transit provider, MAT Paratransit Pennsylvania counties have varying Paratransit services available for their residents. c. The applicant, or a representative of their choice, shall have the opportunity to be heard and present information and arguments in support of his/her position to the Appeals Subcommittee of the Metro Area Mayors’ Committee for People with Disabilities. Individuals who live outside the metropolitan area but travel into the community and utilize MAT Paratransit on a regular basis are encouraged to apply for eligibility. If a decision is not made within 30 days, the applicant will be determined temporarily eligible until such time as the decision regarding the appeal is made by the Committee. Please answer the following questions about your use of the regular bus service. All information will remain confidential. To be eligible to use MAT Paratransit, you must be considered "ADA Paratransit Eligible" as defined by the federal government. Recognizing destinations, understanding transfers, and being able to distinguish between vehicles at busy transfer stations are all examples of navigating the Fixed Route System. Visitors to Fargo-Moorhead who have been certified as "ADA Paratransit Eligible" by another public entity will be provided service up to 21 days during any 365-day period beginning with the visitor’s first use of the service during such 365-day period. You can also download an application from this page. ADA Paratransit is a shared ride, advanced reservation, origin-to-destination service for persons with disabilities who are unable to use the public bus service because of their disability. A written appeal must be filed within 60 days of the date of the letter notifying an individual that they have been determined to be ineligible for ADA Paratransit service. With the exception of assistance provided by the driver or other employees of the service, eligibility under this category is based on a person's ability to independently use the service. East Bay Paratransit was established by AC Transit and BART to meet requirements of the Americans with Disabilities Act (ADA). The MATBUS Mobility Manager is responsible for reviewing applications and determining eligibility. A written appeal must be filed within 60 days of the date of the letter notifying an individual that they have been determined to be ineligible for ADA Paratransit service. Paratransit, Inc. is a Local Public Agency organized as a non-profit 501(c)(3) corporation. ADARIDE offers telephone support on weekdays. Individuals must submit a completed, written application to MATBUS. Spokane Transit Authority. Apply for Paratransit Service You can now fill out your paratransit forms online and submit them via email. Please add any other information that you would like us to know about your abilities or disabilities. Please provide the address of the places you travel to most often. "Any individual with a disability who is unable, as the result of a physical or mental impairment (including a vision impairment), and without the assistance of another individual (except the operator of a wheelchair lift or other boarding assistance device), to board, ride or disembark from any vehicle on the Fixed Route Bus System which is readily accessible to and usable by individuals with disabilities.". Eligibility may be permanent, temporary, seasonal, conditional or transitional. 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