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Blank Metro Access Application PDF Template

The Metro Access Application form serves as a gateway for individuals with disabilities to apply for door-to-door, shared-ride paratransit service provided by MetroAccess. This form is designed to assess eligibility based on specific criteria outlined by the Americans with Disabilities Act (ADA), requiring the submission of detailed personal information, medical certification, and an in-person assessment. To ensure an efficient application process, applicants and their healthcare providers must thoroughly complete and submit the form, following the outlined steps meticulously. For a smoother application experience, click the button below to start filling out your Metro Access Application form.

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The Metro Access Application form serves as a quintessential piece of documentation designed to aid individuals with disabilities in accessing door-to-door paratransit service, thereby facilitating a degree of independence and mobility that could otherwise be compromised. Situated within the intricate web of public transportation options, this form and the accompanying process underscore a commitment to inclusivity, adhering to the Americans with Disabilities Act (ADA) guidelines. Applicants are required to navigate through a systematic process that includes a detailed application, an in-person assessment, and a certification process, all aimed at evaluating the extent to which their disabilities affect their ability to use standard Metrobus and Metrorail services. The procedures outlined within the application package, including instructions for completing the form, required documentation from healthcare providers, and the stipulation of a pre-assessment interview, underscore the thoroughness of this process. Importantly, the application emphasizes the need for appointments and disallows mail or fax submissions, reflecting the personalized nature of the assessment process. Additionally, it lays out provisions for those needing assistance in the application process, including the ability to nominate a representative to act on the applicant's behalf, thereby adhering to principles of accessibility and accommodation. With service areas spanning multiple counties and jurisdictions, the Metro Access service represents a vital link in the public transportation network for many individuals with disabilities, making the application process of significant importance.

Preview - Metro Access Application Form

Application for

MetroAccess Door-to-Door Paratransit Service

For People with Disabilities

DO NOT MAIL OR FAX APPLICATION

Transit Accessibility Center

6005th Street, NW Washington, DC 20001

(Between Chinatown/Gallery Place and Judiciary Square Metro Stations)

(202)962-2700 & select option #5 TTY (202) 962-2033

All Assessments are by Appointment Only

Thank you for yourd oninterMetro’sst in Mdeterminationtro services offoryourpeopleeligibilitywith disabilities. The following services

(A)Reduced Fare Program for People with Disabilities – Eligible people with disabilities

travel on accessible Metrobus and Metrorail for half the regular (rush hour) fare at all times. This

program is available for people with disabilities who use the accessible Metrobus and Metrorailare available base:

system as their primary travel option. For more information on the Reduced Fare program or to

obtain an application please visit our website atunder the section titled “How

dohttp://wwwI get a Metro.wmataDisability.com/accessibility/metroaccessID Card?”_eligibility.cfm

or call (202) 962-2700 and select option 1 from the phone

(B)MetroAccess – Door-to-door, shared ride public paratransit service for people with disabilities who are unable to use regular accessible Metrobus and Metrorail public transportation

for some or all of their public transportation due to a disability. The Americans with Disabilities Act (ADA) outlines specific criteria to determine eligibility for paratransit service and an application anmenu.

in-person assessment is required. MetroAccess operates throughout the metropolitan area where there is regularnd PrincebusGeorge’sand/or railCountyservinceMaryland;. Service isArlingtonprovidedCounty,in Washington,Fairfax County,DC; MontgomeryCity of County a

Alexandria, City of Fairfax, and City of Falls Church in Virginia.

To apply for this service you and your healthcare provider must complete this application. Please read and follow the instructions on page 2.

Instructions

Application revision date: March 2017

Page 1 OF 9

Step 1: Read the entire application and complete Part A.

Step 2: Read Accessible Transportation Options for People with Disabilities and Senior Citizens in

the Washington, DC Metropolitan Area, included with this application packet or also available at http://www.wmata.com/accessibility/doc/Accessible_Transportation_Options.pdf

Step 3: Take the entire application to a healthcare provider holding active licensure or credentials in certifythe areatheofapplication:your disabilityPhysician,to completePhysician’sPart BAssistant,. One of the following health care providers must

Certified Nurse Practitioner, Optometrist

(visual disabilities only), Podiatrist (disabilities of the foot and ankle only) or, Licensed Clinical Psychologist (Psychiatric disabilities only). It is your responsibility to ensure the original signed and completed application is received by the Metro Transit Accessibility Center on the day of your appointment.

Step 4: Upon completion of the application, call 202-962-2700 and select option 5, ( TTY 202-962-2033) to conduct a pre-assessment interview. At that time, a determination will be made as to the type of

appointment and/or assessment that will be required, and an appointment will be made for you. officePleasewithinhave 60yourdayscompletedof the dateapplicationof the healthcareat handprovider’swhen yousignaturecall. Also. Applicatiensure you contact the

ons more than 60

days old will not be accepted. You will be instructed to bring your completed original application with you to the appointment. Do not mail or fax the application. NOTE: We require 24 hours notice if you need to cancel your appointment, except in case of a verified emergency. If you miss or cancel 2 appointments you will be required to complete a new application and be required to wait 120 days to reapply.

Copies, faxes, and scans will not be accepted. Applications with missing information will not be accepted and will be returned to the applicant without processing. Applications that are mailed will be returned to the applicant with instructions to contact the Transit Accessibility Center.

Step 5: Metro will determine your eligibility based on how your disability impacts your functional abilities to use the accessible Metrobus and Metrorail public transportation system. Financial need is not a criterion for MetroAccess eligibility. All assessments take place at the Metro Transit Accessibility Center. If you use a mobility aid, please bring it with you to the assessment. If transportation is needed, advise the Metro Transit Accessibility Center representative at the time of your telephone interview.

If you have questions or need additional information, please contact the Metro Transit Accessibility Center at 202-962-2700 and select option 5, TTY 202-962-2033 or e-mail eligibility@wmata.com. Please do not bring children to the appointment unless the child is the applicant. Please note that the minimum age to apply for the service is 5 years old. The office is open Monday, Wednesday

-Friday from 8:00 AM - 4:00 PM, and Tuesday, 8:00 AM to 2:30 PM. Hours are subject to change without notice so Please call in advance. Phone lines open at 8:30 on all days.



Application revision date: March 2017

Page 2 OF 9

Phone: ( ) ____________________________________

I am a current MetroAccess customer. MetroAccess ID Card # ________________________

I am a current Reduced Fare customer. Reduced Fare ID Card # ____________________

I have access to the internet and/or have an email account.

Part A: APPLICANT INFORMATION AND RELEASE (Copies, faxes or scans will not be accepted)

Last Name______________________________ First Name______________________________ Middle Initial ________

Street Address:	Apartment #:

City, State, Zip:	County or City:

Gender: Male Female Date of Birth: ____/______/________ E-mail:_________________________________

Primary phone number: ( ) _______________________________ Home Cell Phone Work

Secondary phone number: ( ) _____________________________ Home Cell Phone Work

In case of an emergency, who should be notified?

Name:

Relationship:

Mobility Devices: Do you require the use of a mobility device when traveling?  No Yes

Check all that apply: Man	al Wheelchair	 Support C	e Portable Oxygen
Power Wheelchair			800 pounds when occupied
CrutchesWalkerorScooterWhiteupCane(forto 48” xvisually30” andimpaired)no more than Other: _____________________________
Do you use a service animal?	No Yes	Sometimes If yes, please describe the type of
animal and what service(s) the animal was trained to perform:

I certify that all information contained in part A of this application were completed by me or my appointed representative and are true.

Original Signature of Applicant: __________________________________________ Date:_________________________

(Under 18, Signature of Parent or Guardian)

Application revision date: March 2017

Page 3 OF 9

AUTHORIZATION TO HELP ME APPLY FOR METROACCESS SERVICES

Please complete the authorization below if you are providing legal authority to another party to complete this application and act as your agent in the processing of this application.

** This form is only to be used when an applicant is not able to otherwise give consent for

Applicant’sassist ce andNameinformation sharing.

Applicant’s Address______________________________________________________

_____________________________________________________

I would like to apply for MetroAccess door to door paratransit service.

I am appointing _____________________________to help me apply for MetroAccess service. For this

purpose only, he or she has the authority to act on my behalf, including scheduling appointments, completing paperwork, and providing information about me to WMATA (Metro), so long as it relates to my application for MetroAccess service. Metro may release any information it has about me upon request, to this person, including health care information, so long as it relates to my application for services. For this purpose only, my agent may request, receive, and review any information, oral or written, regarding my physical or mental health, including but not limited to, medical and hospital records and other protected health information, and consent to disclosure of this information.

For all purposes related to this document, my agent is my personal representative under the Health Insurance Portability and Accountability Act (HIPAA) and is entitled to request, receive, and review protected health information: any information, oral or written, regarding my physical or mental health, including but not limited to medical and hospital records, and other protected health information. My agent may also consent to disclosure of this information.

Application revision date: March 2017

Page 4 OF 9

This agreement expires: (Select one from options below.)

_____ At the end of my appointment on __________________; or

_____ At the end of my MetroAccess certification process; or

_____ At the end of my MetroAccess certification and any applicable appeal process.

In any event, this agreement would expire no later than one year from when it is signed. I can cancel this agreement at any time by telling the person and calling Metro to inform them that this authorization is no longer valid.

Signature

Date

Printed Name

I, ________________________________________________, agree to help ______________________________ with

(Agent’s Name)

(Applicant’s Name)

his/her application for MetroAccess services. Either I, or another person from my organization, will come with the applicant to their eligibility appointment and assist him/her.

Signature

Date

Printed Name

Application revision date: March 2017

Page 5 OF 9

Part B: HEALTH CARE PROVIDER CERTIFICATION

holding active licensure or credentials in the area of the applicant’s disability orA healthcarethe applicant’sproviderprimary care provider as outlined on page 2 must complete Part B.


Your patient has requested eligibility for MetroAccess services. MetroAccess is a door to door,
uniquely qualified to clarify his or her functional				the applicant’s healthcare provider you are
shared ride paratransit service for people whose disability(ies) prevent them from riding the fixed
route accessible system, all or part of the time. As					icant’s functional abilities we
that you the healthcare provider not the applicant
			abilities and l mitations to ride the M			tro	’s require
accessible bus and rail system. In order to determine this appl
travel independently onhow the applicant’s					complete and certify all of the following

sections. Please detail		disability(ies) impact their ability to board, navigate and
	the accessible fixed route system. Please be as specific as possible

Applicant’s HIPAA Authorization:

I _________________________________authorize the healthcare provider completing this application to

release to the Washington Metropolitan Area Transit Authority (Metro) any protected health information about my disability in order to verify my eligibility for Metro Services for People with Disabilities. I also authorize the release of further information should it be needed for this application for a period of 60 days from the date of my signature on part A of this application.

____________________________________________________________ (Applicant’s name) is being referred for a brief

functional assessment to determine eligibility for Metro services for people with disabilities.

1.Name of Health Care Provider: (Please print)____________________________________________________

2.Phone: ( ) _______________________

3.License Number/State Issued: ___________________________

4.Street Address & Suite #: ________________________________________________________________________________

5.City, State, Zip: ____________________________________________________________________________________________

6.Specialization: ____________________________________________________________________________________________

7.Written Diagnosis (es) and ICD-9CM and/or DSM Code(s): ______________________________________

__________________________________________________________________________________________________________________

8.HYPERTENSION: Eligibility for service is determined by a functional assessment, which is

conducted by a certified/licensed therapist with the Transit Accessibility Center. Applicants may be required to walk/travel up to 1/2 mile. In order to ensure the safety ofe applicant’sthe applicant,restinga bloodB/P is pressure (B/P) reading is taken prior to starting the assessment. If th

Application revision date: March 2017

Page 6 OF 9

160/100 or higher, the assessment will be suspended pending certification by the health care provider that the applicant can complete the assessment. If you are currently treating the applicant for hypertension and certify that he/she is cleared to complete the functional assessment, we may proceed without referring the applicant back to you for evaluation and certification.

9.Are you currently treating this applicant for Hypertension? No Yes

10.Applicant can complete the assessment as described above if B/P does not go above a reading of: ______________________

11.If applicant has a seizure disorder or epilepsy have they had a tonic-clonic seizure within the past 4 months?

No Yes N/A

12.Does the applicant require a Personal Care Attendant (PCA) when traveling on public transportation?

No Yes

13. Does the applicant require any of the following mobility aids listed in question 14?

No Yes

14.Check all that apply: Manual Wheelchair Support Cane Portable Oxygen

Power Wheelchair or Scooter CrutchesWalkerWhite Cane (visually impaired) Other: __________________

15. What is the expected duration of the disability? (Please initial appropriate box)

_____Short-Term: Conditions that last at least 90 days, but are likely to improve within one year.

____Long-Term: Conditions with absolutely little expectation of improvement

16. Does this applicant’s disability(ies) prevent him/her from independently using the accessible Metrobus and Metrorail system?

No Yes the disability or health condition impact the applicant’s ability to travel If yes, HOW does

independently from one location to another on the accessible Metrobus and Metrorail system?

__________________________________________________________________________________________________________________

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Page 7 OF 9

17.If this applicant is currently on medication(s), will the side effects of this significantly reduce or hinder his/her ability to independently ride the accessible Metrobus and Metrorail system?

No Yes N/A

applicant’sIf you selectedabilityyestoforusethisthequestion,accessiblepleasefixedexplainroute bushowandtherailsidesystem:eff cts would hinder this

__________________________________________________________________________________________________________________

Based on the applicant’sENVIRONMENTALdisability(ies),ISSUESpleaseTHATtell usAFFECTif followingTHEenvironmentalAPPLICANT factors affect his/her ability to ride Metro’s accessible bus and rail system.

18.Would extremes in temperature affect this applicant’s ability to ride the accessible Metrobus or Metrorail?

No Yes

If yes, please explain the effect and the extent of the limitation(s)

__________________________________________________________________________________________________________________

19. Would ice and/or snow affect this applicant’s ability to ride accessible Metrobus or Metrorail system?

No Yes

If yes please explain the effect and the extent of the limitation(s)

__________________________________________________________________________________________________________________

20. Would poor air quality affect this applicant’s ability to ride Metrobus or Metrorail? Yes No If yes please explain the effect and the extent of the limitation(s). NOTE: If applicant suffers from Asthma, please indicate if the applicant has been on systemic medication for the immediate past 6 months OR has been required to use fast acting inhalers for three or more episodes per week for the immediate past six months

__________________________________________________________________________________________________________________

Application revision date: March 2017

Page 8 OF 9

21.In your medical opinion what other factors related to the applicant’s disability(ies) affect his/her ability to ride the accessible Metrobus or Metrorail?

__________________________________________________________________________________________________________________

HEALTH CARE PROVIDER SIGNATURE PAGE

I certify that I have completed the questions in Part B and that the information provided is correct.

Original Signature of Physician/Healthcare Provider: ______________________________________________

(Note: Must be original hand signature, not signature stamp)

Printed Name_________________________________________________________Date: _____________________

False certification may be reported to the licensing agency under District of Columbia Code Annotated,

Section 2-3305.15, Code of Virginia 54. 1-2915, or Maryland Health Occupations Code Annotated 14-404 or appropriate code for state of license. Metro reservesn, (2) makethe rightthe finalto: (1)determinationv ify the validityon anofapplicant’sthe licenseeligibilityof the health care provider providing the certificatio

for MetroThes rvicesADA requiresfor peopleMetrowith disabilities,to provideanotificationd (3) retainofa copyan applicant’sof this applicationeligibility. status within 21 NOTE:

days of submitting a completed application. If, for any reason, it takes longer than that to process the determination, the applicant will be eligible to use MetroAccess until Metro completes the eligibility process. This is called "presumptive eligibility." If 21 days have passed since Metro received the completed application the applicant will be automatically granted eligibility for MetroAccess until the review process is completed.

Application revision date: March 2017

Page 9 OF 9

Download Metro Access Application PDF Form

Form Data

Fact Name	Description
Service Type	MetroAccess is a door-to-door, shared ride public paratransit service for people with disabilities.
Eligibility Criteria	Eligibility is determined by the Americans with Disabilities Act (ADA) and requires an application and in-person assessment.
Service Area	Service extends throughout the Washington, D.C. metropolitan area, including parts of Maryland and Virginia.
Application Process	The application involves completing forms and undergoing an assessment. It requires the involvement of a healthcare provider to certify the disability.
Important Instructions	Applications must be received within 60 days of the healthcare provider's signature. Mailed, faxed, or photocopied applications are not accepted.
Contact Information	The Transit Accessibility Center, located in Washington, D.C., is the point of contact for applications and assessments.
Assessment Requirement	All assessments are by appointment only, and eligibility is based on how a disability impacts one's functional abilities to use public transportation.

Instructions on Utilizing Metro Access Application

Filling out the Metro Access Application form is a crucial step towards gaining access to specialized transit services designed for people with disabilities. These services aim to provide a more accessible and inclusive public transportation option for those who might find it challenging to use the standard Metrobus and Metrorail systems due to their disabilities. By following the instructions carefully and providing detailed, accurate information, applicants can efficiently complete the form. The form requires both the applicant and a healthcare provider's input, so preparing in advance and coordinating with the healthcare provider is essential. After the form is filled out, a sequence of steps will confirm the submission and next stages of the application process.

Prepare by reading the entire application packet carefully. Understand each section and gather all necessary information before starting to fill it out.
Complete Part A of the application, which includes Applicant Information and Release. This section requires personal details such as your name, address, phone number, email, and information about any mobility devices you use or if you have a service animal.
Read the Accessible Transportation Options for People with Disabilities and Senior Citizens in the Washington, DC Metropolitan Area document. This provides valuable information that can help you understand more about the services available to you.
Take the application to a healthcare provider who is licensed or holds credentials in the area of your disability. The healthcare provider must complete Part B. The eligible healthcare providers include a Physician, Physician’s Assistant, Certified Nurse Practitioner, Optometrist (for visual disabilities only), Podiatrist (for disabilities of the foot and ankle only), or Licensed Clinical Psychologist (for Psychiatric disabilities only).
After your healthcare provider has filled out their part, call the Metro Transit Accessibility Center at (202) 962-2700 and select option 5, or TTY (202) 962-2033, to schedule a pre-assessment interview. Ensure you have your completed application with you during the call, as you will need to reference it. Remember, applications are only valid for 60 days from the healthcare provider’s signature date.
Attend your assessment appointment at the Metro Transit Accessibility Center, bringing the original signed application and any mobility aids you use. If you require transportation to the appointment, mention this during your pre-assessment interview.

Following these steps carefully will ensure your application process is as smooth as possible. The Metro Transit Accessibility Center's staff is available to assist with questions or concerns. Remember, do not mail or fax the application; it must be brought to your appointment. If necessary, you also have the option to authorize someone else to assist you with your application through a specific authorization section in the form. This could be helpful if you're unable to complete the application independently or need additional support during the process.

Obtain Answers on Metro Access Application

What is MetroAccess?

MetroAccess is a door-to-door, shared ride public paratransit service designed for people with disabilities who are unable to use the regular, accessible Metrobus and Metrorail public transportation for some or all of their travel. This service is provided in compliance with the Americans with Disabilities Act (ADA) and operates in the Washington, DC metropolitan area, including parts of Maryland and Virginia.
How do I apply for MetroAccess service?

To apply for MetroAccess, you and your healthcare provider need to complete an application form. After reading the entire application, fill out Part A, and have your healthcare provider fill out Part B. Healthcare providers may include licensed physicians, physician’s assistants, certified nurse practitioners, optometrists for visual disabilities, podiatrists for foot/ankle disabilities, or licensed clinical psychologists for psychiatric disabilities. Remember, you must bring the original, signed, and completed application to the Metro Transit Accessibility Center by appointment only.
Where do I submit my completed MetroAccess application?

Do not mail or fax your completed application. Instead, you must bring your application to the Metro Transit Accessibility Center located at 600 5th Street, NW, Washington, DC 20001. Please note that this is by appointment only, which you can arrange by calling (202) 962-2700 and selecting option 5 or for TTY (202) 962-2033 after completing your application.
Can I apply for MetroAccess online?

No, currently the application process for MetroAccess requires an original, signed application and an in-person assessment by appointment. However, the initial steps including reviewing and filling out the application can be initiated by downloading the form online and then completing it as instructed.
What information will I need to provide in the application?

In the application, you will need to provide personal information such as your name, address, phone number, email, and details about any mobility devices or service animals you use. Additionally, part of the application must be completed by a healthcare provider who can certify your disability and your need for MetroAccess services.
What happens after I submit my application?

After submitting your application, Metro will conduct a pre-assessment interview and determine the type of in-person assessment required for your case. The final eligibility determination is based on how your disability affects your ability to use Metrobus and Metrorail services. You must ensure your application is submitted within 60 days of your healthcare provider's signature.
Is there an age requirement to apply for MetroAccess?

Yes, the minimum age requirement to apply for MetroAccess service is 5 years old. Applicants under the age of 18 will require a signature from a parent or guardian on their application.
What if I need to cancel or reschedule my appointment?

If you need to cancel or reschedule your appointment, Metro requires at least 24 hours’ notice, except in cases of a verified emergency. Please note, if you miss or cancel two appointments without a valid reason, you will be required to complete a new application and wait 120 days before reapplying.
Can someone assist me in applying for MetroAccess?

Yes, you can authorize someone to assist you with your application process. This includes scheduling appointments, completing paperwork, and communicating with Metro on your behalf. You will need to complete an authorization form included in the application packet to officially designate someone as your representative.
How is financial need considered in the MetroAccess eligibility process?

Financial need is not a criterion for determining eligibility for MetroAccess services. The main factors considered are your disability and how it affects your ability to use the accessible Metrobus and Metrorail public transportation system.

Common mistakes

Not reading the entire application before starting: Many people jump straight into filling out the form without thoroughly reading the instructions or understanding the requirements. This mistake can lead to incorrect or incomplete information being provided. It's crucial to read the entire application, including the instructions on page 2, to ensure an accurate and complete submission.
Overlooking the healthcare provider's section: A common mistake is not giving enough attention to Part B of the application, which must be completed by a healthcare provider. Applicants sometimes forget to take the application to a licensed healthcare provider who can certify their disability. This oversight can delay the process significantly.
Waiting too long to submit the application: The instructions clearly state that applications more than 60 days old from the healthcare provider's signature date will not be accepted. Some applicants miss this crucial detail and assume there's no deadline post the healthcare provider's assessment, leading to their application being rejected for being outdated.
Failing to call for a pre-assessment interview: After completing the application, the next step is to call the Transit Accessibility Center for a pre-assessment interview. Some individuals skip this step, mistakenly believing that completing the form is sufficient, thus failing to schedule the necessary appointment for assessment within the required timeframe.
Not providing original documents: Copies, faxes, and scans of the application are not accepted, yet some applicants attempt to submit these instead of the original signed documents. This results in the application being returned without processing, adding delays to receiving the needed assistance.
Ignoring specific instructions for appointment cancellations and reapplications: It's important not to overlook the note that requires 24-hour notice for appointment cancellations, except in verified emergencies. Missing or canceling two appointments without proper notice necessitates completing a new application and waiting 120 days to reapply, a stipulation often missed, leading to unnecessary delays.

These mistakes can be easily avoided by carefully reading the application instructions, planning accordingly, and ensuring all requirements are met before submission. Doing so will facilitate a smoother application process for MetroAccess services.

Documents used along the form

Applying for MetroAccess Door-to-Door Paratransit Service necessitates thorough preparation, ensuring all essential forms and documents are accurately assembled. Accompanying the Metro Access Application, several crucial forms and documents not only streamline but also empower the application process, enhancing the applicant’s opportunity to gain this vital service. Each document plays a distinct role in substantiating the applicant's eligibility and need for the service. Here’s what often complements the Metro Access Application:

Proof of Disability: Official documentation from a medical professional or government entity affirming the applicant's disability status.
Photo Identification: A government-issued ID, such as a driver's license or state ID, to verify the applicant's identity.
Proof of Residency: Documents like utility bills or lease agreements confirming the applicant’s residency within the service area.
Reduced Fare Program Application: For those who may also qualify for reduced fares on regular transit services, this application is required to process that benefit alongside paratransit services.
Medical Assessment Form: Completed by a healthcare provider, this form details the nature of the applicant's disability and why traditional public transit is not a feasible option.
Authorization to Release Information: This legal document permits healthcare providers to share relevant medical information with transit authority evaluators.
Emergency Contact Information: Forms listing contacts to be notified in case of an emergency during travel.
Mobility Aid Information: Detailed descriptions of any mobility aid the applicant uses, to ensure the service can accommodate their needs.
Income Verification Documents: While financial need is not a criterion for MetroAccess eligibility, some related programs or subsidies might require this information.
Customer Agreement Form: A document where the applicant acknowledges the rules and responsibilities associated with using the MetroAccess service.

Together, these documents form a comprehensive package that supports the Metro Access Application. By accurately completing and furnishing each required form, applicants highlight their specific needs, ensuring the review process is both accurate and empathetic towards providing the essential service of MetroAccess. Ensuring the completeness and accuracy of this documentation is a critical step in accessing specialized public transit services designed to enhance mobility and independence for those with disabilities.

Similar forms

The Metro Access Application form is similar to the Disability Parking Permit Application used by many state Departments of Motor Vehicles (DMV). Both applications require individuals to prove a level of disability through documentation from a certified healthcare provider, asserting the individual's need for special services or accommodations, such as paratransit services or disability parking.
It also shares similarities with the Social Security Disability Insurance (SSDI) application. In both cases, the applicant must provide comprehensive information about their disability, including medical documentation, to qualify for benefits or services. Each process requires assessment of the individual's abilities and limitations.
Another similar document is the Reduced Fare Program application for public transportation systems. Like the Metro Access Application, these documents are designed for individuals with disabilities to receive discounted travel rates. Applicants must provide proof of eligibility, usually through a medical certification or proof of participation in another disability or income-centric program.
The Medicaid Transportation Service Authorization Form is also comparable. This form is required for individuals who need transportation to medical services and is based on their health condition, mirroring the process of proving a disability and the need for specialized transportation services in the Metro Access Application.
The application process for a Paratransit ID Card, used by various transit authorities, closely aligns with the Metro Access Application. Both involve an assessment of the applicant's inability to use standard transit systems independently due to a disability, necessitating a thorough evaluation by healthcare providers.
Lastly, the Job Accommodation Request Form under the Americans with Disabilities Act (ADA) parallels the Metro Access Application. Both require individuals to disclose their disability and request accommodations that would enable participation in work or public transport, respectively. Each form necessitates an evaluation of how the disability affects the individual's daily activities.

Dos and Don'ts

Applying for MetroAccess Door-to-Door Paratransit Service requires careful attention to detail. Here are some important dos and don'ts when filling out the application form:

Do thoroughly read the entire application before you start filling it out. This preparation enables a better understanding of what information is needed.
Do ensure you have access to the internet in order to read the 'Accessible Transportation Options for People with Disabilities and Senior Citizens in the Washington, DC Metropolitan Area', which is crucial for a comprehensive application process.
Do visit a healthcare provider who holds active licensure or credentials in the area of your disability to complete Part B of the application. Their endorsement is critical for validating your need for MetroAccess services.
Do call the Transit Accessibility Center to schedule a pre-assessment interview after you and your healthcare provider have completed the application. Having your completed application at hand during this call is essential.
Do bring the original signed and completed application to your assessment appointment. It is crucial for verifying the accuracy and authenticity of your application.
Don't mail or fax the application. The instructions make it clear that your application must be presented in person to ensure all necessary information has been accurately captured and verified.
Don't forget to notify the Transit Accessibility Center if you need to cancel or reschedule your appointment. It is required to provide at least 24 hours notice, except in the case of a verified emergency.
Don't submit an application older than 60 days from the healthcare provider’s signature. Timeliness ensures that your medical information and need for services are current and accurately reflected.
Don't bring incomplete applications to your appointment. Applications with missing information will not be considered, causing unnecessary delays in your eligibility assessment.

Following these guidelines carefully will enhance your application process for the MetroAccess Door-to-Door Paratransit Service, ensuring a smoother experience for individuals with disabilities seeking transit assistance.

Misconceptions

Many individuals applying for MetroAccess, the door-to-door paratransit service intended for people with disabilities, may have misconceptions during the application process. Here are ten common misunderstandings clarified to assist applicants:

Application must be mailed or faxed. Contrary to this belief, the application process strictly requires individuals to refrain from mailing or faxing their application. Applications are to be brought directly to the Transit Accessibility Center.
Any healthcare provider can complete the application. The application process specifies that only healthcare providers with active licensure or credentials in the area of the applicant's disability are authorized to complete Part B of the application. This includes a niche list of professionals like Physicians, Optometrists for visual disabilities, and Licensed Clinical Psychologists for psychiatric disabilities among others.
The application process is solely document-based. An in-person assessment is necessary for the completion of the application process, emphasizing the importance of a comprehensive evaluation beyond mere paperwork.
Financial need is considered for eligibility. MetroAccess eligibility is based on how an individual’s disability impacts their functional abilities to use public transportation and not on financial need.
Existing MetroAccess customers need to reapply through the full process. Current MetroAccess or Reduced Fare Program users have specific portions within the application acknowledging their status, which could potentially streamline their application process.
Applications older than 60 days post-healthcare provider’s signature are acceptable. There is a clear mandate that applications submitted after 60 days of the healthcare provider's signature will be rejected.
Eligibility assessments can be conducted without an appointment. The process dictates that all assessments are strictly by appointment, emphasizing the structured approach MetroAccess takes towards evaluating new applicants.
Children are allowed during the assessment appointment. Applicants are specifically instructed not to bring children to the appointment unless the child is the applicant, ensuring that assessments are conducted without distractions.
Mobility aids are not considered during the eligibility assessment. If an applicant uses a mobility aid, they are advised to bring it to the assessment, indicating the personalized and thorough nature of the evaluation process.
The application process is inflexible regarding appointment cancellations. While applicants are encouraged to provide 24 hours’ notice for cancellations, exceptions are made in verified emergencies, showing flexibility in the process.

Understanding these clarifications can greatly aid applicants in navigating the MetroAccess application process more effectively, ensuring that eligible individuals can access the transportation services they need.

Key takeaways

Filling out the Metro Access Application form is critical for individuals with disabilities seeking door-to-door, shared-ride public transportation services. This service caters to those who cannot use regular Metrobus and Metrorail services. Here are key takeaways about the application process:

The application must be submitted in person to the Transit Accessibility Center located in Washington, DC. Mailing or faxing the application is not permitted.
Applicants must complete Part A of the application themselves, which gathers basic personal and contact information.
Part B of the application must be filled out by a licensed healthcare provider who can certify the nature of the applicant's disability. Eligible healthcare providers include Physicians, Physician's Assistants, Certified Nurse Practitioners, Optometrists (for visual disabilities), Podiatrists (for foot and ankle disabilities), and Licensed Clinical Psychologists (for psychiatric disabilities).
Before submitting the application, the applicant must contact the Metro Transit Accessibility Center at (202) 962-2700 and select option 5 to schedule a pre-assessment interview and an in-person assessment appointment.
The completed application must be received at the time of the assessment appointment, and applications older than 60 days from the healthcare provider’s signature will not be accepted.
Applicants are required to provide 24 hours notice if they need to cancel their appointment, barring verified emergencies. Missing or cancelling two appointments necessitates filling a new application and waiting 120 days to reapply.
Metro determines eligibility based on how a disability impacts the applicant's functional abilities to use the regular Metrobus and Metrorail system, not on financial need.
If an applicant uses a mobility aid, it should be brought to the assessment. If transportation to the assessment is required, this should be communicated during the pre-assessment interview.
Children should only be brought to the appointment if they are the applicant, and the minimum age to apply for the service is 5 years old.
For applicants unable to fill out or submit their application due to their disabilities, a legal agent can be authorized to act on their behalf.

This application process ensures that individuals with disabilities in the Washington, DC metropolitan area can access the necessary services for their mobility and independence. For further information or assistance, the Metro Transit Accessibility Center can be contacted directly.

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