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ACCESS-A-RIDE SERVICE APPLICATION

1 New APPLICATION Recertification: ID Number _____MTA New York City Transit s paratransit SERVICE , ACCESS-A-RIDE , provides door-to-door transportationwithin New York City on an advance reservation basis to persons who, because of a physical or mentaldisability, are unable to use public transit buses or CRITERIA: You are eligible for ACCESS-A-RIDE if you have a disability that prevents you from using the public buses or subways. We will review your APPLICATION , any medical documentationyou provide, and ask you to undergo an individualized assessment. During the assessment, we will ask youto demonstrate whether you can: go up or down subway stairs; travel to a subway station or bus stop; geton, ride , and exit a subway or bus; and ride or navigate the bus or subway system independently.

If you are unable to complete the form yourself, it can be completed by someone you choose to assist you. Please give the completed application and any supporting documents to the professional certifier. ... No Yes, please indicate the tasks(s) performed Guides me ...

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  Ride, Access, Tasks, Performed, Bunale, Access a ride, You are unable

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