Request a Dallas-Fort Worth Medical Ride

STEP 01 / YOUR JOURNEY

What can we help with?

Choose your serviceNon-emergency medical transportAvailability and assistance confirmed before booking.Wheelchair-accessible vanAvailability and assistance confirmed before booking.Private vehicleAvailability and assistance confirmed before booking.Medical package transportPackage details reviewed before acceptance.

Primary passenger name

Pickup locationDestinationPickup entrance accessDestination entrance accessTrip arrangementReason for transportation

Mobility / access needs

Wheelchair riders

Riders using walkersGuest passenger (one seated guest allowed)

For a package, the owner must confirm that the item and required handling are supported. For a passenger, share access needs without a diagnosis or medical history.

STEP 02 / YOUR SCHEDULE

When would you like to go?

Base rates apply weekdays from 6 AM to 6 PM Central, excluding holidays. Night, weekend and holiday premiums apply. Choose a date to explore preferred pickup times for your call. These planning times do not show confirmed vehicle availability or reserve a ride. Every pickup requires at least 2 hours of lead time. The owner must approve all arrangements, including evening and weekend requests.

Preferred pickup datePreferred pickup time (Central)

Choose a date to load planning times. A minimum 2-hour lead time is required. Call the owner to confirm availability.

Appointment time (optional)

PRIVATE-PAY PLANNING ESTIMATE

Estimate this journey.

Estimate one outbound trip or delivery.

Uses your selected service, wheelchair rider count and preferred pickup schedule. Enter driving miles from a route you have checked. Address suggestions do not measure the route or calculate mileage. The owner confirms your final quote and availability.

Outbound driving miles (enter manually)Total waiting minutes (optional)Estimated tolls / parking ($)Outbound pickup is on a holiday (+75% of the pickup fee)

The first 15 waiting minutes are included. Weekend, after-hours and holiday timing use only the highest premium per leg. Same-day pickup adds one request fee. Each round-trip leg has its own pickup fee and included miles. Check holiday selections with the owner; the planner does not maintain a holiday calendar.

ESTIMATED PRIVATE-PAY FAREEstimate needs calculation

Enter the route, preferred schedule and driving miles, then calculate. No payment is collected by this calculator.

STEP 03 / YOUR CONTACT

Who’s arranging the ride?

Contact namePhone numberEmail (optional)I am arranging this forPayment arrangementPreferred payment method

Medicaid and Veterans Affairs inquiries require confirmation of program arrangements and authorization. This form does not determine coverage. Private-pay quotes are confirmed before booking.

STEP 04 / REVIEW

Let’s check the details.

No current private-pay estimate. Use the estimate in the schedule step or call for a quote.

I understand these are non-emergency planning details. I must call the owner to confirm availability, suitability, price and any payment authorization before booking.

Plan your ride.
Call to arrange it.

What can we help with?

When would you like to go?

Estimate this journey.

Who’s arranging the ride?

Let’s check the details.

Your plan is ready to discuss.

Plan your ride.Call to arrange it.

What can we help with?

When would you like to go?

Estimate this journey.

Who’s arranging the ride?

Let’s check the details.

Your plan is ready to discuss.

Plan your ride.
Call to arrange it.