Please rate Metrolift Application 03-24
Both the eligibility form and the doctor's additional signature must be submitted to METROLift for processing.
Who may help: a friend, guardian, caregiver, agency service representative or family member may help you complete pages 1 to 4.
Physician signature: an additional signature of physician or healthcare professional on letterhead or prescription, verifying completion of application, is required.
Where to send: mail the completed application to METROLift Eligibility, P.O. Box 61429, Houston, Texas 77208-1429.
Denial: intentionally providing false or misleading information, or refusing an in-person interview assessment, is grounds for denial of METROLift services.
| Question | Answer |
|---|---|
| Form Name | METRO 0447-20 |
| Form Length | 6 pages |
| Fillable? | Yes |
| Fillable fields | 160 |
| Avg. time to fill out | 27 min |
| Edition | 03/24 |
| Issuing agency | METRO, Houston |
| Where to send | METROLift Eligibility, P.O. Box 61429, Houston, Texas |
| Matches the agency's file | Yes, checked October 1, 2026 |
| Other names | METRO 0447-20, METROLift Application, Application for METROLift Service |
| Official source | METRO 0447-20 (Rev 03/24), METRO (Houston) |
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Please rate Metrolift Application 03-24
