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For individuals in New York City who cannot utilize standard public transit due to a physical or mental disability, the Application Access Ride form serves as a crucial step toward acquiring the necessary transportation services. This form enables eligible individuals to access the MTA New York City Transit’s Access-A-Ride program, which offers door-to-door service tailored to their unique needs. Whether submitting a new application or recertifying their status, applicants must carefully fill out this document. Providing correct and comprehensive information is essential, as it aids in the determination of eligibility for this paratransit service. The process involves an in-person evaluation at a designated certifier's office, where applicants must present the completed form along with a recent photograph and any supporting documents. It's important to note that all information collected through this process is kept strictly confidential and is utilized solely for assessing service eligibility and the specific assistance required. Furthermore, applicants should be aware that the Access-A-Ride service card is valid for five years, after which recertification will be necessary. Understanding the requirements laid out in the form helps ensure a smooth application process, allowing individuals to receive the transportation support they need.

Application Access Ride Example

MN

ACCESS-A-RIDE SERVICE APPLICATION

New Application

Recertification: ID Number ____________________________

MTA New York City Transit’s paratransit service, Access-A-Ride, provides door-to-door transportation within New York City on an advance reservation basis to persons who, because of a physical or mental disability, are unable to use public transit buses or subways.

INSTRUCTIONS

You must complete this application and bring it with you to the scheduled evaluation at the offices of the professional certifier selected by NYC Transit listed in the cover letter. Please give the completed application and any supporting documents to the professional certifier.

If a question does not apply to you, clearly mark N/A in the space provided. If you have any questions while completing this application, please call 877-337-2017 and when the recorded message begins press “1” for English and “1” for Eligibility. If you are unable to complete the form yourself, it can be completed by someone you choose to assist you. It may take up to 3 weeks to process your application.

One (1) photograph taken within the last three years must be submitted with this application for use on your identification card. Please see the box below for required size. The photograph must have a solid background and show a full view of your face. Please write your name on the back of the photograph. If you do not bring

the photograph with you to the evaluation center, the application process cannot be completed.

All of the information you provide will be used solely for the purpose of determining your eligibility, and any special assistance you may need when using paratransit. The information that you furnish will be kept strictly confidential.

Once issued, an Access-A-Ride paratransit service card expires five (5) years from the date it was issued, unless otherwise indicated.

Do you need information in an alternate format?

Check one: Large Print

Audio Tape

Braille

 

 

 

 

 

 

 

E-mail _________________________________

 

2"

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

Your evaluation will not take place if you arrive at the evaluation

 

 

 

 

 

 

 

center with an incomplete application. You will have to

 

 

 

 

 

 

 

reschedule your evaluation and you may not be provided with

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 1/2"

 

 

transportation for the rescheduled evaluation.

 

 

 

 

 

 

For External Certifier’s Use

Initials _________________________

Date ____________________________

For NYCT Office Use

Application #: ______________________

Date Entered: ______________________

By: ______________________________

1

AGREEMENT TO ELIGIBILITY TERMS AND CONDITIONS (ALL APPLICANTS MUST SIGN THIS AGREEMENT)

I understand that as a part of the application process I must attend an in-person evaluation at the offices of a professional certifier selected by NYC Transit.

I understand that MTA NYC Transit reserves the right to request additional proof of my disability or my inability to use public buses and subways.

I understand that my application will not be accepted at the evaluation center if it is not complete.

I affirm that all of the information that I provide on this application is true to the best of my knowledge. I understand that my application is subject to review and verification, including verification after my Access-A-Ride card has been issued, and that misrepresentation of any material information will lead to termination of my eligibility.

I agree to notify NYC Transit at 877-337-2017 if I no longer need paratransit service for any reason, including a change in my ability to use bus and subway service. I also understand that my failure to cooperate with a request for additional information to verify statements made on my application after my Access-A-Ride card has been issued will be grounds for suspension or termination of my eligibility for paratransit service. I further understand that my failure to adhere to the policies and procedures for using Access-A-Ride are also grounds for suspension or termination of my eligibility for paratransit service.

_____________________________________________

_____________________________________________

Applicant’s Signature

Date

If someone other than the applicant has completed this application, please provide the following information:

_____________________________________________

_____________________________________________

Name

Relationship to Applicant

_____________________________________________

_____________________________________________

Telephone Number

Date

2

REQUIRED IDENTIFICATION INFORMATION (PLEASE PRINT CLEARLY)

____________________________________ ____________________________________

___________

Last Name

First Name

 

 

M.I.

________________________________________________________

______________________________

Street Address

 

 

Apt. No.

 

_______________________________________________

_______

_______________________________

City/Borough

 

State

Zip Code

 

________________________________________________ and ____________________________________________

Cross Streets

___________-_____________-_____________________

__________-_____________-______________________

Home Telephone Number

 

Work Telephone Number

______________________________________________

__________-_____________-______________________

E-mail Address

 

Cell Phone Number

_________-__________-__________

Sex: ______

______

Date of Birth

Male

Female

If your mailing address is different from your home address, please complete the following:

(Otherwise leave blank)

____________________________________________________________

_____________________________

P.O. Box or Street Address

 

Apt. No.

 

______________________________________________________

________________

__________________

City/Borough

State

 

Zip Code

Person to Contact in Case of Emergency: (This section must be completed.)

____________________________

____________________________ _______

Last Name

First Name

M.I.

_____________-____________-__________

_____________-____________-__________

Home Telephone Number

 

Work Telephone Number

Relationship to Applicant: _______________________________________

3

APPLICATION FORM

1.How do you currently travel? (Check all that apply)

Public Transit Bus Subway School Bus Walking Automobile

Access-A-Ride Commuter Railroad

Ambulette

Taxi/Car Service

Other: ____________________________________________

2.Are you registered with the MTA Reduced-Fare program?

Yes

No

3.Do you have a MetroCard? (Check all that apply)

Yes, I use my MetroCard when traveling by bus

Yes, I use my MetroCard when traveling by subway

No, I don’t have a MetroCard

4.Is your disability:

Permanent Temporary I don’t know

5.If temporary, please indicate how long you believe the temporary disability will continue.

2 months 3 months 6 months

Other (Specify): ___________________________________

6.Indicate which support device(s) you use when traveling or walking outside your home.

I do not require a support device

Respirator/Oxygen Tank

Walker

Braces

Support Cane

Scooter*

Crutches

Prosthesis

Service Animal (an animal that provides assistance)

Manual Wheelchair*

Motorized Wheelchair*

Other (Specify) ______________________________________________

*Access-A-Ride vehicles can only accommodate a wheelchair or scooter that is less than 33.5 inches in width and 51 inches in length and does not weigh more than 800 pounds when occupied.

7.If you have a service animal, indicate the tasks(s) your service animal performs for you.

Guides me (vision impairment)

Alerts me (hearing impairment)

Pulls me (manual wheelchair)

Carries items for me

Other (Specify): _____________________________

8.Have you received training to use public transit buses or subways?

Yes

No No, I would like training

I am in the training process

4

9.Would you be able to travel by bus or subway if Access-A-Ride took you from: (Check all that apply)

your home to a bus stop

the bus stop to your home

your destination back to the bus stop

your home to an accessible subway station

the accessible subway station to your home

your destination back to the accessible subway station

Not applicable

10.a. How far from your home is the nearest public transit bus stop?

Less than 1 block 1 to 2 blocks 3 to 4 blocks 5 or more blocks

Identify location of public transit bus stop:

___________________________________________________________________________

b. How long does it take you to walk to the nearest public transit bus stop?

Less than 5 minutes

5-10 minutes

More than 10 minutes

Not sure

11.On your own or using a support device, are you able to get to and from the public transit bus stop nearest your home?

Yes

No

Sometimes—describe the circumstances:

___________________________________________________________________________

12.On your own or using a support device, can you get on, ride, and get off a public transit bus when the “kneeler” is lowered (a kneeler is a device that lowers the front of the bus)?

Yes

No

Sometimes—describe the circumstances: _______________________________________________________________________________

13.How often do you travel on public transit buses?

Daily Weekly Monthly

Occasionally Never

If you have used a public transit bus in the past, when did you stop?

____________ (Mo./Yr.)

Why did you stop traveling by public transit bus?

_________________________________________________________________________________________________________________

14.If you cannot walk up the steps on a bus or use the kneeler, are you able to use the bus lift? (Please note that persons who cannot climb the bus steps have the right to enter the bus by standing on the lift.)

Yes No

Sometimes Don’t Know

5

15.Are you able to identify and understand the destination and route number signs on public transit buses?

Yes

No

Only when the bus operator announces them

Sometimes—describe the circumstances: _______________________________________________________________

16.Are you able to determine when you have reached your destination to get off the public transit bus?

Yes No

Only when the bus operator announces the stop

Sometimes—describe the circumstances:

______________________________________________________________________________________________________________________________________________________________________

17.a. How far from your home is the nearest subway station?

Less than 1 block 1 to 2 blocks

3 to 4 blocks 5 or more blocks

Identify location of subway station:

_______________________________________________

_______________________________________________

b. How long does it take you to walk to the nearest subway station?

Less than 5 minutes

5-10 minutes

More than 10 minutes

Not sure

18.On your own or using a support device, are you able to get to and from the subway station nearest your home?

Yes

No

Sometimes—describe the circumstances:

_________________________________________________________________________________________________________

19.On your own or using a support device, can you ride on an escalator?

Yes No

Sometimes—describe the circumstances: _________________________________________________________________

20.On your own or using a support device, are you able to go to and from the station platform and the street entrance?

Yes

No

Sometimes—describe the circumstances: _____________________________________________

Only if equipped with an elevator

21.On your own or using a support device, how far can you travel on a level street? Please answer in city blocks.

Less than 1 block

1 to 2 blocks

3 to 4 blocks

5 or more blocks

22.On your own or using a support device, can you get on, ride and get off a subway train?

Yes No

Sometimes—describe the circumstances: ________________________________________

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23.Are you able to determine surfaces (platform, top or bottom of stairs) in a subway station?

Yes No

Sometimes—describe the circumstances: ______________________________________________________

24.Are you able to identify and understand the destination and subway line signs?

Yes No

Sometimes—describe the circumstances:

_______________________________________________________

25.Are you able to determine when you have reached your destination to get off the subway?

Yes No

Sometimes—describe the circumstances:

______________________________________________________

Only when the conductor announces the stop

26.How often do you travel using the subway?

Daily Weekly Monthly Occasionally

Not at All

If you have used the subway in the past, when did you stop using it?

___________(Mo./Yr.)

Why did you stop traveling by subway?

______________________________________________________________________________

______________________________________________________________________________

27.a. Do you currently travel with a Personal Care Attendant (PCA), a person such as a home attendant who assists you regularly when you travel outside your home?

Yes

No

Sometimes—describe the circumstances:

__________________________________________________________________________________

__________________________________________________________________________________

I don’t have a Personal Care Attendant

b.If you do need the assistance of a PCA to travel, what kind of traveling assistance does the PCA provide and what specifically does the PCA do for you when he/she travels with you?

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

7

28.If you are unable to take some or all of your trips by public transit bus or subway, check off the reasons below. (Check all that apply)

Not applicable

I feel unsafe traveling by public transit bus

I do not like traveling by city buses

Distance to public transit bus is too long

I do not like traveling by subway

I feel unsafe traveling by subway

Distance to subway is too long

Subway station has no elevators

No curb cuts

No paved sidewalks

Inclement weather

Extreme cold

Hilly streets

Extreme heat

I cannot travel to an unfamiliar place

(The application continues on Page 9).

8

29.a. From the following list, please check off all disabilities or conditions that prevent you from boarding, riding or disembarking from public transit buses or subways.

Cardiovascular/Pulmonary

 

Neuromuscular

 

 

Angina

 

 

___

ALS/Lou Gehrig’s Disease

 

___

Arteriosclerosis/Atherosclerosis

___

Cerebral Palsy

 

___

Asthma

 

 

___

Charcot-Marie Tooth Syndrome

___

Bypass Surgery:

Date: _________________

Equilibrium

 

___

Chronic Obstructive Pulmonary Disease

___

Fibromyalgia

 

___

Congestive Heart Failure

 

___

Hemiplegia/Hemiparesis

 

___

Cystic Fibrosis

 

 

___

Multiple Sclerosis

 

___

Emphysema

 

 

___

Muscular Dystrophy

 

___

Heart Attack:

Date: _________________

Neuropathy

 

___

HTN/Hypertension

 

 

___

Paraplegia

 

___

Peripheral Vascular Disease

___

Parkinson’s Disease

 

___

Phlebitis

 

 

___

Polio

 

___

Thrombosis

 

 

___

Quadriplegia

 

___

Other: ___________________________________

Sciatica

 

___

 

 

 

 

Spina Bifida

 

___

General Medical

 

 

 

Stroke/Cerebral Trauma:

Date: ___________

AIDS

 

 

___

TIA’s (Transient Ischemic Attack)

___

Atrophy

 

 

___

Other: ___________________________________________

Chemotherapy Treatment dates: _______________

 

 

 

_________________________________________

Orthopedic

 

 

Diabetes

 

 

___

Amputation: specify extremity (ies) __________

Edema

 

 

___

_________________________________________________

Epilepsy

 

 

___

Broken/Fracture: __________ Date: ___________

HIV

 

 

___

Degenerative Joint Disease

 

___

Lupus

 

 

___

Gout

 

___

Rheumatoid Arthritis

 

 

___

Hip Replacement

 

___

Kidney Dialysis

 

 

___

Knee Replacement

 

___

Radiation Treatment dates: ___________________

Osteoarthritis

 

___

________________________________________

Osteoporosis

 

___

Other: __________________________________

Scoliosis

 

___

 

 

 

 

Spondylitis

 

___

Vision [Specify eye (s)]

One Eye

Both Eyes

Other: __________________________________

Cataracts

 

___

___

 

 

 

Cortical Blindness

 

___

___

Cognitive/Psychological

 

Glaucoma (all types)

 

___

___

Alzheimer’s Disease

 

___

Macular Degeneration

___

___

ADD/Attention Deficit Disorder

___

Retinal Detachment

 

___

___

Autism

 

___

Legally Blind

 

___

___

Dementia

 

___

Totally Blind

 

___

___

Head Trauma

 

___

Other: ________________________________

Mental Retardation

 

___

 

 

 

 

Panic Disorder

 

___

 

 

 

 

Schizophrenia

 

___

 

 

 

 

Other: __________________________________

9

Toll free from area codes 212, 646, 718, 347, 516, 631, 914, 845
(Press “1” for English and “1” for Eligibility when the recorded message begins.) From all other area codes

b. For each disability or condition checked on previous page, please describe how it prevents you from boarding, riding or disembarking from public transit buses or subways. You may also include medical documentation to support your disability.

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

c. Bring a copy of medical documentation that verifies your transportation related disability to the in-person assessment.

CHECK HERE IF YOU ARE NOT BRINGING MEDICAL DOCUMENTATION TO THE IN-PERSON ASSESSMENT.

30.From your residence, what are the addresses of your three (3) most frequent destinations?

 

 

 

 

 

How Often Do You Travel

 

 

 

 

 

To This Location (Specify)?

Destination Address

 

Cross Streets

Borough

Daily

Wkly

Mthly

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have any questions, please contact Access-A-Ride Customer Information between 9 AM and 5 PM, Monday through Friday.

877-337-2017

718-393-4999

Customers who are deaf call through the relay.

PLEASE REMEMBER THAT YOU MUST:

Submit one (1) photograph measuring 2" x 11/2" that has been taken within the last three (3) years.

Complete and sign the Agreement section.

Complete the application answering every question, and bring it with you when you go to the evaluation center.

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Form Characteristics

Fact Name Fact Details
Application Types Individuals can submit a new application or recertification for the Access-A-Ride service.
Eligibility Criteria Access-A-Ride is designed for individuals unable to use public transit due to physical or mental disabilities.
In-Person Evaluation Requirement Applicants must attend an in-person evaluation at a designated professional certifier selected by NYC Transit.
Processing Time It may take up to three weeks to process the submitted application.
Photograph Requirement A recent photograph, taken within the last three years, is required for the application to be complete.
Renewal Period The Access-A-Ride service card is valid for five years unless otherwise stated.

Guidelines on Utilizing Application Access Ride

Once you've gathered your information, you can begin filling out the Application Access Ride form. Be sure to answer each question carefully and completely. Remember to bring the finished form to your evaluation. A properly filled-out application is essential for a smooth process.

  1. At the top of the form, select either "New Application" or "Recertification" by checking the appropriate box.
  2. If recertifying, fill in your ID number.
  3. Provide required identification information. Print clearly your last name, first name, and middle initial.
  4. Fill out your street address, city, state, and zip code. Include your apartment number if applicable.
  5. Complete the phone number and email sections, specifying your home and work numbers.
  6. Indicate your sex and date of birth.
  7. If your mailing address differs from your home address, provide that information in the specified section.
  8. In the emergency contact section, fill in the last name, first name, and middle initial of the person to contact, along with their phone numbers and relationship to you.
  9. Answer the travel-related questions by checking the boxes that apply to you regarding how you currently travel.
  10. Confirm whether you are registered with the MTA Reduced-Fare program by checking "Yes" or "No."
  11. If applicable, fill out your MetroCard usage details.
  12. Indicate whether your disability is permanent, temporary, or if you are unsure.
  13. If your disability is temporary, specify the expected duration.
  14. Choose the support devices you use when traveling or walking outside your home from the list provided.
  15. If you have a service animal, specify the tasks they assist you with by checking the relevant boxes.
  16. Answer the questions about your training in using public transit.
  17. Provide details on whether you would be able to travel by bus or subway under certain conditions by checking the appropriate boxes.
  18. Answer how far the nearest public transit bus stop is from your home and how long it takes you to reach it.
  19. Indicate whether you can get to and from the bus stop on your own and whether you can get on and off the bus when necessary.
  20. Lastly, answer the frequency of your travel on public transit buses and include any relevant details if applicable.

Once completed, do not forget to include a recent photograph and ensure all sections are filled out to prevent a delay in processing your application.

What You Should Know About This Form

1. What is the Access-A-Ride service?

Access-A-Ride is a door-to-door transportation service provided by MTA New York City Transit. It caters to individuals who, due to a physical or mental disability, are unable to use conventional public transit options like buses or subways. The service requires advance reservations to ensure proper assistance and accommodation.

2. How do I apply for Access-A-Ride?

To apply, complete the Application Access Ride form and bring it to your scheduled evaluation with a professional certifier. It's essential to provide complete and accurate information. If you need assistance completing the form, someone you trust can help you. Remember to attach a recent photograph that meets size requirements for your identification card.

3. What happens if I don’t bring a complete application to the evaluation?

Your evaluation will not take place if you arrive with an incomplete application. If your application is not complete, you will need to reschedule your evaluation. It's crucial to ensure that all parts of the application are filled out correctly to avoid delays in receiving service.

4. How long will it take to process my application?

The processing time for your application may take up to three weeks. Prompt submission of a complete application, along with necessary documentation and your photo, can help ensure a smoother and quicker review process.

5. What should I do if I no longer need paratransit services?

If your circumstances change and you no longer require Access-A-Ride services, it is important to inform NYC Transit. You can do this by calling 877-337-2017. This helps maintain accurate service usage records and assists in resource allocation.

6. How often should I expect to recertify my eligibility?

Your Access-A-Ride service card typically expires five years from the date it was issued unless stated otherwise. Recertification ensures that the information on which your eligibility is based remains current. It is advisable to stay informed about your recertification date and begin the process ahead of time.

7. Is the information I provide confidential?

Yes, all the information you provide on the Access-A-Ride application will be kept confidential. It is used solely for determining your eligibility for the service and understanding any specific assistance you might require. Your privacy is a priority during this evaluation process.

Common mistakes

Completing the Application Access Ride form is a crucial step for individuals seeking paratransit services in New York City. However, applicants often make mistakes that can delay the process. One common error is leaving sections of the application incomplete. Each section must be filled out thoroughly; even if something does not apply, marking it as N/A is essential to avoid confusion. An incomplete application will lead to a canceled evaluation, requiring the applicant to reschedule, which can create unnecessary delays.

Another mistake is failing to provide a recent photograph as specified in the application guidelines. The application requires one photograph taken within the last three years, yet many applicants either forget to include it or fail to meet the specific size and background requirements. If the photograph is not included during the evaluation, the application process cannot proceed, which often leads to frustration for the applicant.

Additionally, some applicants overlook the need to bring supporting documents to the evaluation. Providing sufficient evidence of disability or inability to use public transit is crucial for the application’s acceptance. If these documents are missing, the professional certifier may refuse to process the application. Therefore, it is advisable for applicants to review the required documents ahead of time to ensure they are prepared.

Lastly, misunderstanding the timelines for processing the application can also lead to issues. Applicants may incorrectly assume that their application will be approved immediately after submission. In reality, it may take up to three weeks for the application to be processed. This misunderstanding can create anxiety for those who rely on paratransit services, emphasizing the importance of clear communication regarding processing times.

Documents used along the form

The Application Access Ride form is an essential document for those seeking door-to-door transportation services in New York City through the Access-A-Ride program. Several other documents and forms are often required or recommended during the application process to ensure a smooth evaluation and approval. Below is a list of typical supporting documents that applicants may need to present.

  • Medical Documentation: This form verifies the applicant's disability or condition. Healthcare providers must detail the nature of the disability and its impact on the ability to use public transit.
  • Proof of Identity: Applicants must present valid identification, such as a driver's license or state-issued ID. This document is crucial for ensuring the identity of the person receiving services.
  • Proof of Residency: Documents like utility bills or bank statements can serve as verification of the applicant's address. This helps confirm for the program that the individual resides within the service area.
  • Recent Photograph: A clear photo of the applicant, taken within the last three years, is required. This image is necessary to create the Access-A-Ride identification card.
  • Verification of Public Transit Use: Documentation that shows how the applicant has previously used public transit can strengthen their case. This could include a MetroCard history or letters from transit agencies.
  • Support Needs Form: This additional form may be needed to outline any special assistance requirements the applicant may have during transport. It helps the service provider prepare for the specific needs of the rider.
  • Emergency Contact Information: A separate document that contains details about whom to contact in case of emergencies. This ensures that assistance can be provided swiftly if necessary.

It is important that all forms be completed accurately and submitted alongside the Application Access Ride form to facilitate timely processing. Ensuring that all necessary documentation is included can greatly improve the chances of appointment scheduling and service approval.

Similar forms

  • Medicaid Transportation Request Form: This document requests transportation assistance for individuals who qualify for Medicaid services. Similar to the Application Access Ride form, it requires identification details and information regarding the disability impacting mobility.

  • Paratransit Service Application: Much like the Access-A-Ride form, this application is focused on providing door-to-door service for individuals unable to use conventional public transportation due to a disability. It includes sections for personal information and medical verification.

  • ADA Complementary Paratransit Eligibility Application: This form is used to determine eligibility for paratransit services under the Americans with Disabilities Act. It asks for details regarding an individual's functional ability to use public transit, similar to the Access-A-Ride application.

  • Disability Parking Permit Application: This document enables individuals with disabilities to apply for permits allowing them to park in designated spots. It requires personal identification and confirmation of a disability, similar to the process in the Access-A-Ride application.

  • NYC Reduced-Fare MetroCard Application: Like the Access-A-Ride form, this application allows individuals with disabilities to request a metrocard that offers reduced fare prices, necessitating proof of the disability.

  • Home Health Care Services Application: This document is for individuals seeking home health assistance due to a disability. It has a similar structure in terms of collecting comprehensive health and identification information.

  • Welfare Program Enrollment Form: Applicants for government assistance programs often fill out this form, which also seeks personal and health-related information to assess eligibility, akin to the Access-A-Ride application.

  • Social Security Disability Benefits Application: This form is used to apply for disability benefits and requires substantial documentation regarding the applicant's medical condition, much like the requirements outlined in the Access-A-Ride form.

  • In-Home Support Services Application: This application requests personal and health information to provide additional support for those with disabilities at home. It mirrors the detailed personal inquiries similar to those found in the Access-A-Ride form.

  • Emergency Response Services Registration: Those needing immediate assistance can complete this form. It collects individual information and specific needs in a manner comparable to the structured approach in the Access-A-Ride application.

Dos and Don'ts

When filling out the Application Access Ride form, keep the following guidelines in mind:

  • Do: Complete all sections of the application accurately.
  • Do: Clearly mark “N/A” for any questions that don’t apply to you.
  • Do: Provide a recent photograph as specified, ensuring it shows a clear view of your face against a solid background.
  • Do: Bring any supporting documents to the evaluation appointment, along with your completed application.
  • Don't: Submit an incomplete application, as it will lead to rescheduling the evaluation.
  • Don't: Forget to write your name on the back of your submitted photograph.
  • Don't: Leave any required sections blank; this can delay the process.
  • Don't: Provide false information, as it could result in the termination of your eligibility.

Misconceptions

Misconceptions about the Application Access Ride form can create confusion for applicants. Here are ten common misconceptions and clarifications on each:

  • Only people with permanent disabilities can apply. Many individuals with temporary disabilities can also qualify for Access-A-Ride services.
  • The form can be filled out by anyone, regardless of their relationship to the applicant. While someone can assist in completing the form, the applicant must provide certain personal information and sign the application.
  • You don’t need a photo if you’ve applied before. A recent photo taken within the last three years is required with each application.
  • The evaluation process is quick and doesn’t require a complete application. Your evaluation will be postponed if the application is incomplete, which may delay your access to services.
  • Access-A-Ride is for emergency transportation only. This service is a regular, pre-scheduled transport option for people who cannot use public transit.
  • Personal information is shared with everyone involved in the process. All information provided is confidential and only used to assess eligibility.
  • Once you get the card, you never have to do anything else. Access-A-Ride cards must be renewed every five years, and your eligibility may be reviewed periodically.
  • You can submit the application at any time without following specific steps. You must attend an in-person evaluation to complete the application process.
  • There is no assistance available for filling out the form. If you need help, someone can assist you with completing the form.
  • It’s not necessary to notify Transit if your needs change. You must inform NYC Transit if you no longer need paratransit services or if your condition changes.

Understanding the facts about the Application Access Ride form can help streamline the process and ensure that eligible individuals can access the transportation they need.

Key takeaways

1. Access-A-Ride is designed for those with physical or mental disabilities who cannot use public transit.

2. Complete the Application Access Ride form and bring it to your evaluation appointment. Failing to do so may delay your application.

3. If assistance is needed while filling out the form, someone you trust can help you complete it.

4. Ensure your application is complete before arriving; otherwise, your evaluation may be rescheduled.

5. Include one recent photograph that meets the specified requirements. The application cannot proceed without it.

6. Information submitted will remain confidential and will only be used to assess your eligibility and needs.

7. Your Access-A-Ride card is valid for five years. Keep track of this expiration date for timely renewal.

8. You can request information in alternative formats such as large print, audio tape, Braille, or email.

9. Accurate information is crucial. Misrepresentation may lead to the termination of your eligibility for the service.