Health Care Ride Request Form

If you submit a request and we do not get back to you, we cannot provide the ride.

There are no more health care rides available until February 1

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Your request has been sent. We will contact you to confirm if we can give you a ride.

Is the rider a minor? (All minors must be accompanied an adult.)(required)
Will the rider be accompanied by any other individual?(required)
If the above number is a cell phone, would you like to receive text message confirmation? (required)

By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging. No mobile information will be shared with third parties/affiliates. Please see the privacy policy for more information.

Has the rider ever had a ride with Project CAR?
Does the rider use any kind of mobility aid like a walker or cane? (We do not provide any wheelchair transit.)(required)