Request a Trip
Trip Request
Passengers
Summary
Trip Request
Pickup Address
Please select a valid pickup address
Apt/Unit
Add Stop
Stop Address
Please choose a stop address
Stop Time
Please enter expected wait time
Remove Stop
Drop-off Address
Please select a valid dropoff address
Apt/Unit
Trip Type
Wheelchair
Stretcher
Ambulatory
Wheelchair (Bariatric/Electric)
Stretcher (Bariatric)
Delivery Services
One-Way
Roundtrip
Patient's Weight (lbs)
lb
Driver Escort
Standard Dropoff
Driver Escort
Do you require any of the following equipment to be provided?
No, I do not need any equipment.
Wheelchair
Oxygen
Stair Chair
Child Booster Seat
Child Car Seat Front or Rear Facing
Do you have a wheelchair?
Pickup Date & Time
ETA:
Service not available during that time.
Please select another time or date.
Please choose a pickup date and time
Return Date & Time
ETA:
Service not available during that time.
Please select another time or date.
Please choose a return date and time
Request Now
Passengers
First Name
Enter your First Name
Last Name
Enter your Last Name
Phone #
Enter your Phone #
Alternate Phone #
Email
Passengers (Ages 2+)
Children (Under 2)
Booster Seats
Assistance Requirements
No Assistance
Have any Special Requirements?
Tell us what else we need to know for your trip
Trip Request
Summary
Summary
Round-Trip
One-Way
Driver Escort
Door to Door Assist
Stop at :
For :
Special Requirements:
Your Info
+ 1 More!
Booster Seats
Driving Time
Distance
Cost
Billing Info
Company Name
First Name
Last Name
Email
Credit Card
Payment successful, please wait.
Pay now
Terms and Conditions
1. Trips are considered booked after you receive confirmation from us by either phone or email. 2. Cancellation and No-Show: Cancellations made less than 24 hours before the scheduled trip, or passenger no-shows, may be charged 50% of the total trip cost. 3. Off Hours: For trips scheduled after 6:30 pm, before 7:00 am, on weekends, or on federal holidays, a $90 off hours fee applies in addition to the quoted trip price. 4. Infectious Disease Fee: If you currently have, or have recently been diagnosed with, an infectious or communicable disease, additional fees may apply for required safety precautions, protective equipment, cleaning, or special transportation arrangements.
Passengers
Confirm
Powered by
Thank You!
×
Thank you for your request, we will respond with confirmation shortly.
Terms and Conditions
×
