Submit a Request for Transportation Services

Online Transportation Service Request Form

Please submit your request at least 1 week in advance. Submitting a request through this form is not a booking guarantee. One of our Transportation Coordinators will contact you within 2 to 3 business days to follow up on your request. Please do not use this form for cancellations or to make changes.

Are you currently registered for services? * Required
- Yes
- No. Please phone 519.354.6221 & dial ext. 246 to sign up before submitting a drive request.
Is the requested drive more than 1 week away? * Required
- Yes
- No. Please phone 519.354.6221 and dial ext. 242 for CHAP-CareLink and ext. 275 for adVANtage.
Transportation Services * Required
Please select which transportation service you require.
- adVANtage - Eligible passengers are: rural and/or low-income people ages 0 to 60; unable to access existing public transit systems, unable to drive, or afford private transportation; able to pay a fee for transportation services or qualify for third party invoicing; able to ride safely and independently in a vehicle.
- CHAP-CareLink - Eligible passengers are: older adults age 60+ travelling for a medical appointment or social engagement; adults with disabilities 18+ travelling for a medical appointment; ambulatory and/or able to operate their mobility devices/transfer with minimal assistance.
Do you require an accessible vehicle? * Required
If you find it difficult, or are unable to, use conventional transit or passenger vehicles due to mobility issues, please select yes.
- Yes
- No
Name * Required
First Last
Phone * Required
Please provide your primary number so our team can follow up with you.
Email
Request Details * Required
In the space provided, please provide us with the details of the drive, including the requested date, time, destination & number of passengers.
Agreement - Please review and confirm by checking all boxes. * Required
I understand and agree to the following:
- Drivers are not trained caregivers and are unable to lift passengers or enter residences. If a passenger requires assistance due to health or safety concerns, a family member or caregiver over age 18 must accompany them, free of charge.
- If the passenger is under the age of 18, a family member or caregiver over age 18 must accompany them, free of charge.
- Fares vary based on requested destination and include one stop. Additional destinations and lengthier drives may be provided for an additional cost.
- Submission of this form does not guarantee a drive. A Transportation Coordinator will follow up to advise that the drive is booked or put on a waitlist.
Email
This field is for validation purposes and should be left unchanged.

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Submit a Request for Transportation Services

Online Transportation Service Request Form

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