Ride Request
Request a non-emergency medical ride
For patients, caregivers, discharge planners, and facility coordinators booking scheduled appointments, discharges, and transfers.
This form starts a ride request. It does not confirm the ride automatically. Dispatch reviews the details first and confirms the pickup window after availability is checked.
What this form is for
Use it for scheduled appointments, hospital discharges, and facility transfers.
What to have ready
Pickup and drop-off details, appointment timing, and how the rider can travel safely.
What happens next
Dispatch reviews availability and confirms the pickup window before the ride is scheduled.
Step 1 of 520% complete
Start your request
Pickup and drop-off detailsStart with the addresses so we can verify the trip is inside our service area.
Request review
Submitting this form starts a request. Dispatch still reviews availability and confirms the pickup window before the ride is scheduled.
Submitting a request does not reserve a ride or guarantee availability.
Need service details before you finish the request? Review service levels or use the contact page for non-urgent questions.