Octa Paratransit Application PDF Details

The City of Toronto is pleased to offer octa paratransit, a curb-to-curb transportation service for people with disabilities who cannot use conventional transit service. The octa paratransit application form is now available. Eligible applicants can receive door-to-door transportation from their home to any destination within the City of Toronto.

Here are several facts you may want to review before you start working with the octa paratransit application.

QuestionAnswer
Form NameOcta Paratransit Application
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesocta access application pdf, route 26 octa, oc access, access transportation orange county

Form Preview Example

OCTA ADA PARATRANSIT APPLICATION

After completing this application, call OCTA ACCESS Eligibility Contractor

to schedule your in-person assessment at (714) 560-5956 ext. 2, TDD (714) 560-5474.

1. PERSONAL INFORMATION – please print clearly

Last Name: ______________________ First: _________________ Middle Initial: ____

Female Male

*Social Security

Date of Birth

(Last 4 digits only)

*The Federal Act of 1974 requires that disclosure of your social security number is voluntary. If given, it will be used for identification purposes only.

Home Address

Street _________________________

City _______________

State ____

Zip ______

Day Phone

(_____) ________-________________

TDD

Yes

No

Evening Phone

(_____) ________-________________

 

 

 

 

 

 

 

 

 

 

Mailing Address (If different from above)

 

 

 

 

 

Street _________________________

City _______________

State ____

Zip ______

Emergency Contact

Name: _________________________________________________________________

Day Phone (____) _______-___________ Evening Phone (____) ______-___________

Do you require information in an alternate format?

 

Yes

No

 

If yes, please indicate:

 

 

Braille

Large Print

 

Other ___________________

 

 

 

 

 

Your primary language:

 

 

English

Spanish

 

Other ___________________

 

 

 

 

 

 

2. MOBILITY INFORMATION – please print clearly

What is your disability? ___________________________________________________

Which of the following mobility aids or equipment do you use?

 

Power wheelchair

 

 

 

Manual wheelchair

 

 

 

Scooter

 

 

 

 

 

 

 

 

 

 

 

Crutches

 

 

 

 

Cane

 

 

 

Walker

 

Oxygen Tank

 

 

 

Service Animal

 

 

Other ___________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature ____________________________________

Date _____________________

VERY IMPORTANT! – DO NOT MAIL

You must bring a valid photo identification and this completed ADA

paratransit service application to your in-person assessment appointment.

Rev 2/7/07

ACCESS Service

ACCESS Service (General Information)

ACCESS is a shared-ride paratransit service that is available to qualified applicants whose physical or cognitive limitations prevent them from utilizing OCTA’s regular fixed route bus service.

ACCESS service is provided within a ¾ mile of, and during similar hours as, OCTA’s regular fixed route service. ACCESS service/scheduling guidelines include scheduling trips within 60 minutes of the requested time, picking up customers within a quoted 30 minute pick-up window and ride times generally not exceeding 90 minutes for each trip.

ACCESS Fares

The standard fare is $3.60 per passenger for each one-way trip within Orange County. There is an additional charge of $5.00 each time a driver goes to the door (for customers who prefer to be escorted) to pick up or to drop off a rider.

Curb to curb service at pick-up & destination = $3.60

Door to curb service at either pick-up or destination = $8.60 ($3.60 + $5.00)

Door to door service at both pick-up & destination = $13.60 ($3.60 + $5.00 + $5.00)

These are total amounts for a ONE-WAY ride. If you book a round trip, remember to calculate the amount for both ways.

Eligibility

Eligibility is determined by 3 factors:

Individual's ability to get to/from the bus stop

Individual's ability to board/exit the bus

Individual's cognitive ability to navigate the regular bus system.

February 18, 2013

Operational issues not used to determine eligibility, include:

Age

Distance

Overcrowded buses

Weather conditions

Lack of bus service to an area

Operational issues are not considered in the eligibility process. These are issues that affect any individual, whether they suffer from a disability or not. The individual's disability (ies) and how it affects their functional ability to use regular bus service is the only criterion used in determining eligibility.

ACCESS eligibility may be granted for up to 5 years. Customers wishing to continue ACCESS service must reapply and complete the eligibility process prior to their eligibility expiration date in order to prevent a lapse in ACCESS service.

Certification Process

The certification process consists of a completed application and a one hour in-person functional assessment. If using a mobility device, please bring the device to the interview. ACCESS service may be made available to and from the in-person functional assessment upon request; standard ACCESS fares ($3.60 to $13.60) and scheduling guidelines apply (see page 1). The entire assessment process may take from 4 to 6 hours. Photo ID is needed to verify customers for the in-person assessment.

Individuals are notified by mail regarding their eligibility determination. If you become eligible for the ACCESS service, you will receive an ACCESS identification number and a Rider's Guide describing the ACCESS service and booking process in more detail.

For additional information or assistance, please contact the ACCESS eligibility department at (714) 560-5956 or review the OCTA website at www.octa.net

To apply for OCTA Paratransit Service, call the OCTA ACCESS Eligibility Contractor to schedule your in-person assessment at (714) 560-5956 ext. 2, TDD (714) 560-5474.

February 18, 2013

Watch Octa Paratransit Application Video Instruction

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