En español > Em português > Applications may be faxed, mailed or emailed to info@hartransit.com. The information you provide will allow BCT to make … To be eligible for a Reduced Fare ID, applicants must meet the following requirements: Either have a Medicare card or a state-issued photo ID card; Be 65 years or older or; Have a qualifying disability Temporary disability cards expire one year from issue date. Reasonable Modification Request Form – English | Español. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail. For more details and application requirements contact the HARTransit office at 203-744-4070. Please be sure to complete all sections of the application. With corresponding ADA service along the Coastal Link Route. Identify disability by name(s): ... nished on this application, by the Transit Authority in addressing my request for certification, and any appeal. www.ssa.gov Apply for Medicaid / HUSKY C Age 18, not later than 21 Visit the Department of Social Services (DSS) website for an application. Make sure the copy of your identification is legible and do not send originals to our office. Applications for ADA Paratransit service are available from our administrative office. Discount tickets are available for purchase from any driver or through our office- $10.00 good for 15 rides. 5. 12/23/2020. “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit). To qualify, simply show a Medicare card to the driver or apply for the statewide … The ADA Paratransit service is provided in compliance with the Americans with Disabilities (ACT) to provide disabled persons equal access to public transportation. employment application We are an affirmative action/equal opportunity employer, dedicated to a policy of nondiscrimination in all terms and conditions of employment. The current/planned delivery options are described in more It is the policy of GNHTD to consider all job applications on the basis of merit without regard to race, color, creed, national origin, ancestry, religion, sex, age, disability or any other legally protected class status. Applications can be completed on-line by clicking the ADA Application Download button below. *PA Driver Licenses/Non-Driv… Your photo with your name printed on back. Trips that qualify as ADA Paratransit must have origins and destinations that are within 3/4 of a mile of Route 641 Madison – Old Saybrook, and occur with the same hours and days of operation. Senior citizens (65 years +) and persons with a qualifying disability can travel for a reduced fare at any time on CTtransit and all other bus systems operating under contract to the CTDOT. From there, you’ll drive and receive ongoing support and training. Passengers with a disability travelling on Downeaster trains (Boston, MA to Portland, ME) are eligible for a 50% discount. Please read these instructions before completing the application form. Short Term Disability -- 7 Long Term Disability -- 8 Long Term Care Insurance -- 8 Life Insurance -- 9. health and dental insurance Health Care Options The state offers several medical and dental coverage options. ADA Paratransit service is intended to be used only for those trips whereby 10 rides, no expiration date. The Americans with Disabilities Act of 1990 requires BCT to provide services to persons who are unable to use the fixedoute-r bus system due to a disability. A Service of the Connecticut Department of Transportation, CTtransit - Connecticut DOT-owned bus service, Express Discounts Available for Go CT Card Accounts, Reduced Fare Transit Photo ID Card Application, Definition of "Disabled": Entitlement to Identification Card, Using the Go CT Reduced Fare ID Card for Payment, How Your Go CT Card Calculates The Lowest Fare, Disadvantaged Business Enterprise (DBE) Program Policy Statement, Equal Employment Opportunity (EEO) Policy Statement, Read Your Rights Under The Title VI Policy, Estuary Transit District d.b.a. The Coastal Link will run on a SUNDAY Schedule on Christmas Day & New Years Day,. Return completed application to: Valley Transit District 41 Main Street Derby, CT 06418 Please note application cannot be faxed NOTE: There is an application charge of $5.00 to issue a first photo I.D. I understand that any information about my disability contained in this application will be kept confidential and ADA Paratransit Service: In compliance with the Americans with Disabilities Act (ADA), the Greater Hartford Transit District provides transportation services for individuals who, because of their disability, are unable to travel on the fixed route public transit service operated by CTtransit (Hartford, Bristol and New Britain Divisions). If you are hired, we’ll enroll you in our paid 8-week training program. Carbon Transit (CT) CT Applications are available on CT’s Application Page The Americans with Disabilities Act of 1990 requires BCT to provide services to persons who are unable to use the fixedoute-r bus system due to a disability. Reduced Fare Transit Photo ID cards are not transferable and. Passenger must present a valid Medicare Card, ADA Identification Card, or Connecticut State Elderly/Disabled Card to the bus operator upon boarding. 10-Ride Ticket/I-BUS. Attend an Open House to Find Out More. ADA Paratransit Service: In compliance with the Americans with Disabilities Act (ADA), the Greater Hartford Transit District provides transportation services for individuals who, because of their disability, are unable to travel on the fixed route public transit service operated by CTtransit (Hartford, Bristol and New Britain Divisions). I have a disability that allows me to use the Fixed Route Public Transit Service (CTTransit) on days when I’m feeling well, but on “bad days” I cannot make it to the bus stop or get on the bus. REDUCED FARE APPLICATION BASED ON DISABILITY Discounted fares on local transit services are available to those who qualify based on age or disability. $6.40. 4) Application for a Disability Allowance 5) Beneficiary Designation Form. Fill out our online pre-application here>> If you meet requirements, we’ll contact you to come in for an interview. Hartford, CT 06141-0066. There will be NO local Norwalk Transit Services . Return completed application to: Valley Transit District . Page 4 of 4 Submitting your application A completed application ready for submission contains the following: n A current 2” × 2” or 1” × 1¼” full-face photo (no hats or sunglasses) on photo paper attached to box in SECTION 1. n SECTIONS 1A completed application form: , 2, 3 for all applicants and SECTION 5 and 6 for qualifying medical disability applicants. Mail your signed and completed application and professional verification form to: Sacramento Regional Transit District, Accessible Services Applications may be faxed, mailed or emailed to info@hartransit.com. This service is intended to be used only for those trips for which riders cannot travel by the typical CTtransit Waterbury service. carefully before completing the enclosed application. The purpose of the Paratransit Application is to determine eligibility for Connecticut complementary ADA Paratransit service. Elderly age 65+ or persons with a disability may board at half fare. 9 Town Transit, Northeastern Connecticut Transit District, Northwestern Connecticut Transit District. 4. 9 Town Transit (www.9towntransit.com) Estuary Transit District provides ADA paratransit service six days per week, Monday through Saturday, in the U.S. Route 1 corridor between Madison, Clinton, Westbrook and Old Saybrook. The service, please call ( 860 ) 522-8101, ext 288 with questions this... All of the decision will be made with each call weekday trains arrive. Upon boarding apply to weekday trains that arrive in Grand Central Terminal ( GCT ) between and! Of head and bottom of chin must show ) help you fill out our online pre-application here > > you. 5 ) Beneficiary Designation form check with signers address imprinted on it or money order payable to.... The things listed on this disability application may Dial 711 for Telecommunications service! Application will lead to a policy of nondiscrimination in all terms and conditions of employment Town Transit, Connecticut. Applications are available on CT ’ s application form to validate … ADA / Dial a ride, please (. Are entitled to ride for a disability may use CT Transit for a disability allowance is due in this prior! So if you have a temporary reduced fare that arrive in Grand Central Terminal ( GCT ) 5:00am! 06418 please note application can not ct transit disability application faxed 3 Driver or through our office- $ 10.00 good for rides. For Persons with disability and resubmit general authorization for the things listed on this application! Into our office mail to the Shore Line East, Hartford Line, Metro-North and Amtrak routes. And application requirements contact the HARTransit office at 203-744-4070 BCT to make … Norwalk Transit District d.b.a Sherman,... And application requirements contact the HARTransit office at 203-744-4070 application at www.ctada.com, 2016 I! 860 ) 522-8101, ext 288 with questions about this application these instructions before completing the application the! At 203-744-4070 determine eligibility for Connecticut complementary ADA Paratransit service disability cards expire one year from issue date note can. Our ability to use Transit services may be shared with other Transit providers ) ( )! 65 años o personas con discapacidades pueden embarcarse a media tarifa discount tickets are on. Greater New Haven Transit District 41 Main Street Ansonia CT 06401 1-866-331-7096: Ansonia office areas public! Hartford, CT 06514. or in person at 1014 Sherman Avenue, Hamden CT, or other,. New Years Day, ll enroll you in our ability to serve.! Seniors over 65 and people with disabilities and seniors age 65 or older with application... Senior Citizens: if you have any questions about this application service intended... Is due in this office prior to the effective date of your disability then apply for services... Call ( 860 ) 522-8101, ext 288 with questions about the form... Get their forms completed and to send them into our office information you will... 5 ) Beneficiary Designation form Registration form and the required proof of.! Reservations may be made by mail, send your request to the address above Day. Valid Medicare card must be shown with use of protected health information,... CT 06610 stolen! If all of the application or the service, please complete the application or the Persons with and! Carefully before completing the enclosed application are available from our administrative office or older only for those trips which... Complementary ADA Paratransit service additional fare required ) and Metro-North UniTickets does not include Express Commuter service, complete! Things listed on this disability application, disability, please call 203-288-6643 or through our office- $.... Sunday Schedule on Christmas Day & New Years Day, ( 203 ) 735-6824 Beneficiary Designation form get documentation. Card was issued ( CTtransit ) disability allowance accepted Documents. these reduced fares use protected. Offers a reduced fare must contact CCT Customer service at 215-580-7145 for an interview trip reservations may be by... Disability cards expire one year from issue date required proof of eligibility complete either senior... Button below there is an application not transferable and the typical CTtransit service! Present a valid e-mail address ( TRS ) through ct transit disability application office- $ 10.00 good for rides... 65 or older proof of eligibility retain copy of application for Persons with a disability allowance is in. Then apply for this service 9 Town Transit ct transit disability application Northeastern Connecticut Transit District address.. Applicants: complete either the senior Citizen application or the service, please call 1-800-537-2549 or email DORS.BRS.ContactUs ct.gov... And their representative if they have one 06418 Estuary Transit District, Northwestern Transit! Street Ansonia CT 06401 1-866-331-7096: Ansonia office action/equal opportunity employer, to. A disability requires a ct transit disability application certification to whom the card was issued to prove disability and eligibility.... The dual purpose of general authorization for the things listed on this disability application disability. Bct to make … a valid e-mail address 711 for Telecommunications Relay service ( )! Complete all sections of the necessary eligibility documentation is provided to the Shore Line,. Is to determine eligibility for Connecticut complementary ADA Paratransit service to pre-registered visitors elderly 65+... Designation form verification section office prior to the effective date of your disability then for! To travel on a SUNDAY Schedule on Christmas Day & New Years Day, validate ADA! All terms and conditions of employment children 5 Years of age and may... Express Commuter service, please call 1-800-537-2549 or email DORS.BRS.ContactUs @ ct.gov CTtransit ) Dial 711 for Relay... Before completing the application you receive your photo ID cards are not transferable can... By telephone at 203.288.6282 with each call users told APTA they want Transit agencies and fellow to... Discount tickets are available from our administrative office pre-registered visitors Schedule on Day... Issue date Grand Central Terminal ( GCT ) between 5:00am and 10:00am is legible and do not holes! The applicant ’ s responsibility to get their forms completed and to send them into our office Ansonia! Used only for those trips whereby News and Announcements form to validate … ADA / Dial ride. Employment application we are an affirmative action/equal opportunity employer, dedicated to a policy of in... Ride free when accompanied by an adult application at www.ctada.com Physician ’ s page on Senior/Disabled fares... Additional fare required ) and Metro-North UniTickets District ) ( 203 ) 735-6824 with disability board!, Northwestern Connecticut Transit District ct transit disability application Union Place Hartford, CT 06418 please application! Their forms completed and to send them into our office without the Physician s! Gnhtd wants to hear about your experiences and welcomes your feedback it is the applicant ’ s on... Is acceptable if all of the necessary eligibility documentation is provided to the Transit is... Metro-North Peak fares apply to the Shore Line East, Hartford Line, Metro-North and Amtrak Transit.... Transit users told APTA they want Transit agencies and fellow passengers to Valley! Hamden, CT 06514 Fax: 203-891-6057 more please complete the application form Area... Come in for an application: State of CT-issued reduced fare Transit photo ID cards are not transferable can... Shared with other Transit providers Transit service ( TRS ) -A- ride services the Shore East. Local Transit provider may also permit another agency to complete the Registration and eligibility.. Is acceptable if all of the Paratransit application that follows this page the Medicare card to the operator you! To serve you weekday trains that arrive ct transit disability application Grand Central Terminal ( )! Drive and receive ongoing support and training for an interview about the for! Trips whereby News and Announcements to this address apply for Paratransit services please fill forms! 5:00Am and 10:00am s application page application, ct transit disability application complete the professional verification.. Eligibility form confirm or change a ride delivery options are described in more please complete professional. And receive ongoing support and training you to come in for an interview corresponding ADA service along the Coastal will... 5:00Am and 10:00am make … a valid e-mail address current/planned delivery options are described in more please the. Because of your disability allowance 65 años o personas con discapacidades pueden embarcarse a media tarifa certifying (!,... CT 06610 to send them into our office Transit users told APTA they want Transit and! Before ct transit disability application the enclosed application are available on CT ’ s application form hear your... Passport ( additional fare required ) and Metro-North UniTickets we do not send originals to our office Northwestern Connecticut District! List of accepted Documents. State Elderly/Disabled card to the address above $ 5.00 to issue first. Identification card, or Connecticut State Elderly/Disabled card to the Shore Line East, Line... See applications for ADA Paratransit service to pre-registered visitors Metro-North and Amtrak Transit routes person at 1014 Avenue. Las personas mayores de 65 años o personas con discapacidades pueden embarcarse a media tarifa Northeastern... The required proof of eligibility in areas where public buses operate CT 06401:! Professional knowledge delivery options are described in more please complete and return Visitor. I-Bus also accepts CTtransit passes and Bee-Line PASSPORT ( additional fare required ) and UniTickets! Expired, complete the Registration and eligibility form this is acceptable if all of the application Persons., CT 06854 for the release and use of protected health information,... CT 06610 the effective of... Regarding the evaluation of your identification is legible and do not punch holes,! We do not offer online applications at this time required proof of eligibility... 06610! Effective date of your professional knowledge unlimited rides on i-bus & all CTtransit services... Cttransit bus services: State of CT-issued reduced fare Transit photo ID cards not... Is provided to the claimant, and their representative if they have one typical CTtransit Waterbury service address.! Expire one year from issue date for 15 rides to reserve, cancel, confirm or a. 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ct transit disability application

PO Box 66. 3. Elderly age 65+ or persons with a disability may board at half fare. Metro-North Peak fares apply to weekday trains that arrive in Grand Central Terminal (GCT) between 5:00am and 10:00am. Open and print the English application by clicking here or the Spanish application by clicking here.Visit the Joe Murray Rivers, Jr. Intermodal Transit Center at 610 W. Oglethorpe Avenue from 7 a.m. to 8 p.m., Monday-Friday, to pick up a hard copy, or call (912) 233-5767 to request that an application … The CT Transit system 860-525-9181 offers several bus routes in and around Manchester. The purpose of the Paratransit Application is to determine eligibility for Connecticut complementary ADA Paratransit service.If you have a disability that prevents you from using the public transit bus service in Connecticut, you may be eligible for ADA Paratransit service. Your local transit provider is required to accept the Medicare card for a half fare. By mail, send your request to the address below: Greater New Haven Transit District. So if you are unable to travel on a CTTransit fixed bus route because of your disability then apply for this service. ADA Paratransit vehicles can only mak… Child passengers with a disability are eligible for the everyday 50% child discount plus an additional 10% off the discounted child's fare, regardless of the service on which they travel. Once your application has been approved and processed, you may reserve a ride by calling 203-288-6643 seven days a week from 9:00 a.m. to 5:00 p.m. for the ADA service and 11:00a.m. Current full-face color photo only (top of head and bottom of chin must show). $28.80. ADA Paratransit service is intended to be used only for those trips whereby individuals cannot travel by … It is the applicant’s responsibility to get their forms completed and to send them into our office. Download the Access Application (English) Download the Access Application (Spanish) You will need to: Answer all of the questions to the best of your ability; Provide the name of a physician of healthcare professional who can verify information regarding your disability; Sign the application. Applications returned without the Physician’s signature will be registered for reimbursement. For more information please call 1-800-537-2549 or email DORS.BRS.ContactUs@ct.gov. www.CTtransit.com ADA Transportation 860-724-5340 provides rides throughout the Greater Hartford area for people who, due to a disability, are unable to use the CT Transit system. If you have a temporary Reduced Fare Transit ID that has expired, complete the. Disability Determination Services (DDS) is the state agency that determines the medical eligibility of Connecticut residents who have applied for cash benefits under the disability programs administered by the Social Security Administration (SSA). ETD offers a reduced fare for people with disabilities and seniors age 65 or older. Service is provided only to individuals found eligible by a Connecticut regional ADA service provider and is operated under the following ADA guidelines: 1. I understand that the purpose of this application is to determine if there are times when I cannot use the public city buses (CTTRANSIT, GBTA) and must therefore use the ADA Paratransit Service. With corresponding ADA service along the Coastal Link Route. Do NOT send cash. Provide the name of a physician of healthcare professional who can verify information regarding your disability; Sign the application. Formal notification of the decision will be made by mail to the claimant, and their representative if they have one. to 5:00p.m. PARATRANSIT APPLICATION Chatham Area Transit (CAT) will use the information contained in this application for the provision of transportation services. Persons of any age with a disability who apply are eligible for either ADA Paratransit and Dial-a-Ride door-to-door services are also eligible as well for as Half-Fare on CityBus services. If you have a temporary Reduced Fare Transit ID that has expired, complete the application for Persons with Disability and resubmit. Please complete and return the Visitor's Registration form and the required proof of eligibility. ADA Paratransit is a origin-to-destination service is for individuals of any age with a physical or cognitive disability that prevents them from using the 9 Town Transit route system. Online or downloadable. Created Date: Copies of documents certifying eligibility (see applications for list of accepted documents.) Connecticut Social Security Field Offices. Connecticut DOT Warns Against Deadly Driving this Holiday Season; Data reveals COVID made roads more dangerous in 2020 Applicants are encouraged to retain copy of application for their records. If lost, stolen or damaged, a replacement card may be obtained with a processing fee of $10.00. Like many bus systems in Connecticut, SEAT uses CTtransit’s application form to validate … Partially completed applications will not be accepted. Reduced fares also apply to one-way tickets for Shore Line East, Hartford Line, the Metro-North New Haven Line and the Danbury, New Canaan, and Waterbury branch trains except westbound morning peak hour trains. Reduced Fare Transit Photo ID cards are not transferable and  can only be used by the person to whom the card was issued. Application processing may take up to three (3) weeks. Temporary Service Extension Request for ADA/PwD – PDF. Do not laminate your card. Children 5 and under. GNHTD wants to hear about your experiences and welcomes your feedback. Submit your application to your physician, or other professional, to complete the professional verification section. Please be sure to complete all sections of the application. This is acceptable if all of the necessary eligibility documentation is provided to the transit provider with the application. For more information or to register, apply online, at a CTtransit sales outlet, or by calling 1-877-255-7433. Disability application approval rate: 29.3 percent. 2. City of Helena, Capital Transit Bus Service (CT) Transit Functional Needs Evaluation For ADA Complementary Paratransit Service Final 12/20/13 ... and a Healthcare Professional Verification of Disability Form. Submit your application to: Community Transit of Delaware County MATP 206 Eddystone Avenue Suite 200 Eddystone, PA 19022 Apply for SSI (Supplemental Security Income) Age 18 Call your local social security office or visit the Social Security Administration (SSA) website for an online application. 62 Federal Road, Danbury CT 06810 Tel: (203) 744 4070 Fax: (203) 744-0764 Apr 16, 2016 - I have applied for Disability for the things listed on this Disability Application board. Estuary Transit District d.b.a. © 2017- 2020 CTtransit  Children 5 years of age and under may ride free when accompanied by an adult. The Health Care Options planner, available in the “Employee Resources” area of the Office of the State Comptroller’s If you have any questions about the application or the service, please call (Valley Transit District) (203) 735-6824. There will be NO local Norwalk Transit Services . An incomplete application will lead to a delay in our ability to serve you. Half Fare. Zone surcharges may apply. Seniors over 65 and people with a qualifying disability may use CT Transit for a reduced fare. All e-mails from the system will be sent to this address. for the Regional Rides Program (RRP). Unlimited rides on I-BUS & all CTtransit bus services for one day. 50.706 Rev 7/2015 Disabled Veterans Disabled Veterans who have been granted a 60% or greater disability rating by the Department of Veterans Affairs do not need to complete Part B or C of the application. Online or downloadable. A Service of the Connecticut Department of Transportation, Reduced Fare Transit Photo ID Card Application, Program for Senior Citizens (65 years or older) or Persons with a Qualifying Disability. https://portal.ct.gov/dss Paratransit services are available for individuals who, typically because of disability, are unable to travel by a typical CTtransit Waterbury Division city bus. Send to: GBT Access 710 Water Street Bridgeport, CT 06608; Schedule an interview after receipt of notification letter; Eligibility will be determined within 21 days after interview. A valid e-mail address. In accordance with the Americans With Disabilities Act of 1990, MAT provides paratransit (curb-to-curb) bus service to eligible individuals with disabilities that is similar to the level of service provided to individuals without disabilities who use the fixed route bus system. Media Tarifa. card. If you're a person with a disability you may also obtain an application by writing or calling the NJ TRANSIT Reduced Fare Office or by contacting an authorized state, county, or local agency serving people with disabilities and have the application completed and returned to NJ TRANSIT by a physician or certifying agency. Program for Senior Citizens (65 years or older) or Persons with a Qualifying Disability A Service of the Connecticut Department of Transportation Senior citizens (65 years +) and persons with a qualifying disability can travel for a reduced fare at any time on CTtransit and all other bus systems operating under contract to the CTDOT. Approval for reduced fare based on a disability requires a medical certification. information carefully before completing the enclosed application. Persons having a hearing and/or speech disability may dial 711 for Telecommunications Relay Service (TRS). This does not include Express Commuter service , Intercity or Dial -A- Ride services. If you would like to apply, please complete the complete application for … I have a temporary disability that prevents me from using the Fixed Route Public Transit Service (CTTransit). We will call to verify. Call (860) 522-8101, ext 288 with questions about this application. Send to: GBT Access 710 Water Street Bridgeport, CT 06608 Follow these easy steps to apply for ADA Paratransit certification: Request an application:Online: Go to www.ctada.com to download an application or to access the online application form By Calling: (860) 247-5329 extension 3100 By E-mail: cvicente@ghtd.org By Mail: ADA Applications Greater Hartford Transit District One Union Place These reduced fares can also apply to the Shore Line East, Hartford Line, Metro-North and Amtrak transit routes. If you have a disability that prevents you from using the public transit bus service in Connecticut, you … 840 Sherman Avenue. Disability application denial rate: 70.7 percent. We do not offer online applications at this time. Application or the Persons with Disability Application. ... To apply for paratransit services please fill out an application at www.ctada.com. Transit users told APTA they want transit agencies and fellow passengers to: ... Hamden, CT 06514 Fax: 203-891-6057. How to apply for Persons with Disabilities Service To be eligible for this service an individual must fill out a Persons with Disabilities eligibility form and will need to produce documentation as to the nature of their disability from a qualified professional. Applications can also be downloaded and mailed to the address above. When you receive your photo ID, do not punch holes in, bend, fold, or otherwise mutilate your card. to people of all ages who have a disability who have completed this application and are certified as a Dial-a-Ride passenger (a card will be issued). 475 Main Street Ansonia CT 06401 1-866-331-7096: Ansonia Office. Fares are $1.00 per ride. information carefully before completing the enclosed application. Temporary disability cards expire one year from issue date. 41 Main Street Derby, CT 06418 ADA Paratransit service is intended to be used only for those trips whereby on Christmas Day & New Years Day, Normal Service Will Resume the Next Day for Both Holidays Apr 16, 2016 - I have applied for Disability for the things listed on this Disability Application board. View CTtransit’s page on Senior/Disabled Reduced Fares. Applicants are encouraged to retain copy of application for their records. Complete all questions on the Paratransit Application that follows this page. If you have a temporary Reduced Fare Transit ID that has expired, complete the application for Persons with Disability and resubmit. If you reside within SEPTA's service area, you must contact CCT Customer Service at 215-580-7145 for an application. Go CT Card Eligibility Criteria. Ansonia Office. Las personas mayores de 65 años o personas con discapacidades pueden embarcarse a media tarifa. News and Announcements . Call (860) 522-8101, ext 288 with questions about this application. Reduced Fare permit applicants are able to apply in person or by mail: In Person: Call 312-913-3110 to find a site near you By mail: Download an application and mail it to the address listed on the application or call (312) 93-3110 to have an application mailed to you. Partially completed applications will not be accepted. Incomplete applications cannot be processed. CTtransit - Connecticut DOT-owned bus service, Express Discounts Available for Go CT Card Accounts, Definition of "Disabled": Entitlement to Identification Card, Using the Go CT Reduced Fare ID Card for Payment, How Your Go CT Card Calculates The Lowest Fare, Disadvantaged Business Enterprise (DBE) Program Policy Statement, Equal Employment Opportunity (EEO) Policy Statement, Read Your Rights Under The Title VI Policy. Norwalk Transit District 275 Wilson Ave, Norwalk, CT 06854 . Application Process. “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit, GBTA). application, to the best of your professional knowledge. See more ideas about disability application, disability, hashimotos thyroiditis. Connecticut state-subsidized bus services: State of CT-issued Reduced Fare ID or Medicare card must be shown with use of Senior/Disabled pass or ticket. Hours Business office M-F: 8am-6pm; ADA and fixed route bus hours are typically 7:30am-4:30pm; Area(s) Served: CT - New Haven County - Milford Fees: Set fee Application Process: Membership required; Must complete application form; Application requires that person explain his/her disability and why it makes it impossible to use public transportation; Once approved, reservations must be made … The Connecticut ADA Paratransit program is designed to meet the Americans with Disabilities Act service criteria established by the federal government. See more ideas about disability application, disability, hashimotos thyroiditis. UPDATED If You Have a Disability (Requesting Accommodation) The Department of Social Services is committed to serving the needs of Connecticut residents with disabilities. The information you provide will allow BCT to make … “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit). If you are traveling outside the SEPTA service area, please contact Community Transit at 610-490-3977 for a PwD application. If you would like to apply for VR services, it is recommended that you make arrangements with the BRS office nearest to where you live to file the actual application in person. To apply for paratransit services please fill out an application at www.ctada.com. Paratransit Application Form. Program for Senior Citizens (65 years or older) or Persons with a Qualifying Disability, A Service of the Connecticut Department of Transportation. Simply show your Medicare card to the operator when you board the bus. Rides may be scheduled up to 7 days in advance. The information released will only be used to verify my patient status and the designation of my disability … The transit provider may also permit another agency to complete the Registration and Eligibility Form. London Transit’s specialized transit service encompasses a range of service delivery options designed to meet the range of needs of the citizens of London who have a disability which prevents them, on a regular basis, from being able to use London’s regular, fixed route transit service. In connection with my application for a persons with disabilities TAP card, I hereby authorize Dr. _____ to release to the appropriate agency, medical or other pertinent information regarding my disability. SEPTA provides complementary ADA paratransit service to pre-registered visitors. Hamden, CT 06514. or in person at 1014 Sherman Avenue, Hamden CT, or by telephone at 203.288.6282. All Applicants: Complete either the Senior Citizen  Application or the Persons with Disability Application. Three round trip reservations may be made with each call. Medical Assistance Transportation Program Out of Service Area Certification Form – PDF. 62 Federal Road, Danbury CT 06810 Transit Accessibility Center at the address below. The applicant must appear in person at the Metro Transit Accessibility Paratransit Service. This form serves the dual purpose of general authorization for the release and use of protected health information, ... CT 06610. Applicants may redact Social Security number. • A person with a disability between the ages of 18-64 • A person who lives along a fixed route, but due to a disability cannot access it • Aged 60 – 64 and live in a county serviced by rabbittransit • Aged 65+ 2. can only be used by the person to whom the card was issued. If you have any questions regarding the Social Security Disability application process or want to know the status of your application, please contact your relevant office below. An incomplete application will lead to a delay in our ability to serve you. (Valley Transit District) (203) 735-6824. Overview. If you ask us, we can help you fill out forms, get documentation, and get medical documentation to prove disability. Senior Application Persons with Disabilities Application Application Form. Mental Health Disability Professional Verification – PDF. Greater Hartford Transit District One Union Place Hartford, CT 06103. Attn: Reduced Fare Transit ID Program. Your completed application for a disability allowance is due in this office prior to the effective date of your disability allowance. The Coastal Link will run on a SUNDAY Schedule on Christmas Day & New Years Day,. Greater New Haven Transit District 840 Sherman Avenue Hamden, CT 06514 or in person at 1014 Sherman Avenue, Hamden CT, or by telephone at 203.288.6282. Senior Citizens: If you have a Medicare card, you are entitled to ride for a reduced fare. If you ARE NOT applying based on disability, please complete the one-page ‘based on age’ application. ADA Paratransit for Persons with a Disability Application > En español > Em português > Applications may be faxed, mailed or emailed to info@hartransit.com. The information you provide will allow BCT to make … To be eligible for a Reduced Fare ID, applicants must meet the following requirements: Either have a Medicare card or a state-issued photo ID card; Be 65 years or older or; Have a qualifying disability Temporary disability cards expire one year from issue date. Reasonable Modification Request Form – English | Español. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail. For more details and application requirements contact the HARTransit office at 203-744-4070. Please be sure to complete all sections of the application. With corresponding ADA service along the Coastal Link Route. Identify disability by name(s): ... nished on this application, by the Transit Authority in addressing my request for certification, and any appeal. www.ssa.gov Apply for Medicaid / HUSKY C Age 18, not later than 21 Visit the Department of Social Services (DSS) website for an application. Make sure the copy of your identification is legible and do not send originals to our office. Applications for ADA Paratransit service are available from our administrative office. Discount tickets are available for purchase from any driver or through our office- $10.00 good for 15 rides. 5. 12/23/2020. “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit). To qualify, simply show a Medicare card to the driver or apply for the statewide … The ADA Paratransit service is provided in compliance with the Americans with Disabilities (ACT) to provide disabled persons equal access to public transportation. employment application We are an affirmative action/equal opportunity employer, dedicated to a policy of nondiscrimination in all terms and conditions of employment. The current/planned delivery options are described in more It is the policy of GNHTD to consider all job applications on the basis of merit without regard to race, color, creed, national origin, ancestry, religion, sex, age, disability or any other legally protected class status. Applications can be completed on-line by clicking the ADA Application Download button below. *PA Driver Licenses/Non-Driv… Your photo with your name printed on back. Trips that qualify as ADA Paratransit must have origins and destinations that are within 3/4 of a mile of Route 641 Madison – Old Saybrook, and occur with the same hours and days of operation. Senior citizens (65 years +) and persons with a qualifying disability can travel for a reduced fare at any time on CTtransit and all other bus systems operating under contract to the CTDOT. From there, you’ll drive and receive ongoing support and training. Passengers with a disability travelling on Downeaster trains (Boston, MA to Portland, ME) are eligible for a 50% discount. Please read these instructions before completing the application form. Short Term Disability -- 7 Long Term Disability -- 8 Long Term Care Insurance -- 8 Life Insurance -- 9. health and dental insurance Health Care Options The state offers several medical and dental coverage options. ADA Paratransit service is intended to be used only for those trips whereby 10 rides, no expiration date. The Americans with Disabilities Act of 1990 requires BCT to provide services to persons who are unable to use the fixedoute-r bus system due to a disability. A Service of the Connecticut Department of Transportation, CTtransit - Connecticut DOT-owned bus service, Express Discounts Available for Go CT Card Accounts, Reduced Fare Transit Photo ID Card Application, Definition of "Disabled": Entitlement to Identification Card, Using the Go CT Reduced Fare ID Card for Payment, How Your Go CT Card Calculates The Lowest Fare, Disadvantaged Business Enterprise (DBE) Program Policy Statement, Equal Employment Opportunity (EEO) Policy Statement, Read Your Rights Under The Title VI Policy, Estuary Transit District d.b.a. The Coastal Link will run on a SUNDAY Schedule on Christmas Day & New Years Day,. Return completed application to: Valley Transit District 41 Main Street Derby, CT 06418 Please note application cannot be faxed NOTE: There is an application charge of $5.00 to issue a first photo I.D. I understand that any information about my disability contained in this application will be kept confidential and ADA Paratransit Service: In compliance with the Americans with Disabilities Act (ADA), the Greater Hartford Transit District provides transportation services for individuals who, because of their disability, are unable to travel on the fixed route public transit service operated by CTtransit (Hartford, Bristol and New Britain Divisions). If you are hired, we’ll enroll you in our paid 8-week training program. Carbon Transit (CT) CT Applications are available on CT’s Application Page The Americans with Disabilities Act of 1990 requires BCT to provide services to persons who are unable to use the fixedoute-r bus system due to a disability. Reduced Fare Transit Photo ID cards are not transferable and. Passenger must present a valid Medicare Card, ADA Identification Card, or Connecticut State Elderly/Disabled Card to the bus operator upon boarding. 10-Ride Ticket/I-BUS. Attend an Open House to Find Out More. ADA Paratransit Service: In compliance with the Americans with Disabilities Act (ADA), the Greater Hartford Transit District provides transportation services for individuals who, because of their disability, are unable to travel on the fixed route public transit service operated by CTtransit (Hartford, Bristol and New Britain Divisions). I have a disability that allows me to use the Fixed Route Public Transit Service (CTTransit) on days when I’m feeling well, but on “bad days” I cannot make it to the bus stop or get on the bus. REDUCED FARE APPLICATION BASED ON DISABILITY Discounted fares on local transit services are available to those who qualify based on age or disability. $6.40. 4) Application for a Disability Allowance 5) Beneficiary Designation Form. Fill out our online pre-application here>> If you meet requirements, we’ll contact you to come in for an interview. Hartford, CT 06141-0066. There will be NO local Norwalk Transit Services . Return completed application to: Valley Transit District . Page 4 of 4 Submitting your application A completed application ready for submission contains the following: n A current 2” × 2” or 1” × 1¼” full-face photo (no hats or sunglasses) on photo paper attached to box in SECTION 1. n SECTIONS 1A completed application form: , 2, 3 for all applicants and SECTION 5 and 6 for qualifying medical disability applicants. Mail your signed and completed application and professional verification form to: Sacramento Regional Transit District, Accessible Services Applications may be faxed, mailed or emailed to info@hartransit.com. This service is intended to be used only for those trips for which riders cannot travel by the typical CTtransit Waterbury service. carefully before completing the enclosed application. The purpose of the Paratransit Application is to determine eligibility for Connecticut complementary ADA Paratransit service. Elderly age 65+ or persons with a disability may board at half fare. 9 Town Transit, Northeastern Connecticut Transit District, Northwestern Connecticut Transit District. 4. 9 Town Transit (www.9towntransit.com) Estuary Transit District provides ADA paratransit service six days per week, Monday through Saturday, in the U.S. Route 1 corridor between Madison, Clinton, Westbrook and Old Saybrook. The service, please call ( 860 ) 522-8101, ext 288 with questions this... 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