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Incomplete applications cannot be processed. 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 … Reasonable Modification Request Form – English | Español. Service is provided only to individuals found eligible by a Connecticut regional ADA service provider and is operated under the following ADA guidelines: 1. Applications can also be downloaded and mailed to the address above. NOTE: There is an application charge of $5.00 to issue a first photo I.D. Fares are $1.00 per ride. We do not offer online applications at this time. See more ideas about disability application, disability, hashimotos thyroiditis. Mail your signed and completed application and professional verification form to: Sacramento Regional Transit District, Accessible Services If you would like to apply, please complete the complete application for … Please be sure to complete all sections of the application. Children 5 years of age and under may ride free when accompanied by an adult. See more ideas about disability application, disability, hashimotos thyroiditis. 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. Hamden, CT 06514. or in person at 1014 Sherman Avenue, Hamden CT, or by telephone at 203.288.6282. 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. “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit, GBTA). Paratransit Service. 62 Federal Road, Danbury CT 06810 Tel: (203) 744 4070 Fax: (203) 744-0764 With corresponding ADA service along the Coastal Link Route. Paratransit services are available for individuals who, typically because of disability, are unable to travel by a typical CTtransit Waterbury Division city bus. 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. 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. ADA Paratransit for Persons with a Disability Application > En español > Em português > Applications may be faxed, mailed or emailed to info@hartransit.com. To apply for paratransit services please fill out an application at www.ctada.com. application, to the best of your professional knowledge. (Valley Transit District) (203) 735-6824. Passengers with a disability travelling on Downeaster trains (Boston, MA to Portland, ME) are eligible for a 50% discount. Application processing may take up to three (3) weeks. Half Fare. card. 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. Make sure the copy of your identification is legible and do not send originals to our office. Applications returned without the Physician’s signature will be registered for reimbursement. Please be sure to complete all sections of the application. For more information please call 1-800-537-2549 or email DORS.BRS.ContactUs@ct.gov. For more information or to register, apply online, at a CTtransit sales outlet, or by calling 1-877-255-7433. These reduced fares can also apply to the Shore Line East, Hartford Line, Metro-North and Amtrak transit routes. A decision on a disability application in Connecticut can generally be made within 90-120 days, in line with national averages. PARATRANSIT APPLICATION Chatham Area Transit (CAT) will use the information contained in this application for the provision of transportation services. Temporary Service Extension Request for ADA/PwD – PDF. employment application We are an affirmative action/equal opportunity employer, dedicated to a policy of nondiscrimination in all terms and conditions of employment. The Connecticut ADA Paratransit program is designed to meet the Americans with Disabilities Act service criteria established by the federal government. Program for Senior Citizens (65 years or older) or Persons with a Qualifying Disability, A Service of the Connecticut Department of Transportation. Your completed application for a disability allowance is due in this office prior to the effective date of your disability allowance. To qualify, simply show a Medicare card to the driver or apply for the statewide … This service is intended to be used only for those trips for which riders cannot travel by the typical CTtransit Waterbury service. The information released will only be used to verify my patient status and the designation of my disability … Unlimited rides on I-BUS & all CTtransit bus services for one day. Copies of documents certifying eligibility (see applications for list of accepted documents.) For more details and application requirements contact the HARTransit office at 203-744-4070. Apr 16, 2016 - I have applied for Disability for the things listed on this Disability Application board. © 2017- 2020 CTtransit  Application Form. 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. 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 … 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. 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. Discount tickets are available for purchase from any driver or through our office- $10.00 good for 15 rides. ADA Paratransit vehicles can only mak… Check with signers address imprinted on it or money order payable to CTtransit. 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). If you have a disability that prevents you from using the public transit bus service in Connecticut, you … Formal notification of the decision will be made by mail to the claimant, and their representative if they have one. This is acceptable if all of the necessary eligibility documentation is provided to the transit provider with the application. View CTtransit’s page on Senior/Disabled Reduced Fares. There will be NO local Norwalk Transit Services . ADA Paratransit service is intended to be used only for those trips whereby ADA Paratransit service is intended to be used only for those trips whereby individuals cannot travel by … Hartford, CT 06141-0066. Identify disability by name(s): ... nished on this application, by the Transit Authority in addressing my request for certification, and any appeal. 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. Please complete and return the Visitor's Registration form and the required proof of eligibility. Senior Application Persons with Disabilities Application information carefully before completing the enclosed application. Online or downloadable. An incomplete application will lead to a delay in our ability to serve you. Applicants may redact Social Security number. 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. Temporary disability cards expire one year from issue date. Do not laminate your card. 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. $28.80. 4. If you have a temporary Reduced Fare Transit ID that has expired, complete the. Temporary disability cards expire one year from issue date. 12/23/2020. https://portal.ct.gov/dss 475 Main Street Ansonia CT 06401 1-866-331-7096: Ansonia Office. 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. All e-mails from the system will be sent to this address. Overview. ADA / Dial A Ride . Estuary Transit District d.b.a. 840 Sherman Avenue. When you receive your photo ID, do not punch holes in, bend, fold, or otherwise mutilate your card. 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. To reserve, cancel, confirm or change a ride, please call 203-288-6643. Call (860) 522-8101, ext 288 with questions about this application. With corresponding ADA service along the Coastal Link Route. 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. Three round trip reservations may be made with each call. I have a temporary disability that prevents me from using the Fixed Route Public Transit Service (CTTransit). Mail Completed Application and Supporting Documents to: Application processing may take up to three (3) weeks. Mental Health Disability Professional Verification – PDF. Return completed application to: Valley Transit District . Reduced Fare Transit Photo ID cards are not transferable and  can only be used by the person to whom the card was issued. for the Regional Rides Program (RRP). Application or the Persons with Disability Application. 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. to 5:00p.m. Disability application denial rate: 70.7 percent. A valid e-mail address. By mail, send your request to the address below: Greater New Haven Transit District. • 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. Ansonia Office. 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. 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. 10-Ride Ticket/I-BUS. on Christmas Day & New Years Day, Normal Service Will Resume the Next Day for Both Holidays Mail Completed Application and Supporting Documents to: CTtransit. Created Date: Paratransit Application Form. Make sure the copy of your identification is legible and do not send originals to our office. application, to the best of your professional knowledge. If you have a temporary Reduced Fare Transit ID that has expired, complete the application for Persons with Disability and resubmit. Passenger must present a valid Medicare Card, ADA Identification Card, or Connecticut State Elderly/Disabled Card to the bus operator upon boarding. This form serves the dual purpose of general authorization for the release and use of protected health information, ... CT 06610. We will call to verify. The Coastal Link will run on a SUNDAY Schedule on Christmas Day & New Years Day,. All-Day Pass/I-BUS. ETD offers a reduced fare for people with disabilities and seniors age 65 or older. Complementary service is only provided in areas where public buses operate. Senior Citizens: If you have a Medicare card, you are entitled to ride for a reduced fare. The ADA Paratransit service is provided in compliance with the Americans with Disabilities (ACT) to provide disabled persons equal access to public transportation. Applications for ADA Paratransit service are available from our administrative office. Approval for reduced fare based on a disability requires a medical certification. There will be NO local Norwalk Transit Services . The CT Transit system 860-525-9181 offers several bus routes in and around Manchester. Children 5 and under. © 2017- 2020 CTtransit  From there, you’ll drive and receive ongoing support and training. 9 Town Transit, Northeastern Connecticut Transit District, Northwestern Connecticut Transit District. If you are hired, we’ll enroll you in our paid 8-week training program. Partially completed applications will not be accepted. Do NOT send cash. 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 10 rides, no expiration date. Attn: Reduced Fare Transit ID Program. ADA Paratransit service is intended to be used only for those trips whereby “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit). Please read these instructions before completing the application form. Seniors over 65 and people with a qualifying disability may use CT Transit for a reduced fare. ... To apply for paratransit services please fill out an application at www.ctada.com. 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. Fill out our online pre-application here>> If you meet requirements, we’ll contact you to come in for an interview. Transit users told APTA they want transit agencies and fellow passengers to: ... Hamden, CT 06514 Fax: 203-891-6057. Partially completed applications will not be accepted. Applications can be completed on-line by clicking the ADA Application Download button below. Simply show your Medicare card to the operator when you board the bus. Elderly age 65+ or persons with a disability may board at half fare. SEPTA provides complementary ADA paratransit service to pre-registered visitors. CT TEACHERS’ RETIREMENT BOARD. Metro-North Peak fares apply to weekday trains that arrive in Grand Central Terminal (GCT) between 5:00am and 10:00am. 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). Your local transit provider is required to accept the Medicare card for a half fare. 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. can only be used by the person to whom the card was issued. Current full-face color photo only (top of head and bottom of chin must show). *PA Driver Licenses/Non-Driv… The transit provider may also permit another agency to complete the Registration and Eligibility Form. If you are traveling outside the SEPTA service area, please contact Community Transit at 610-490-3977 for a PwD application. Las personas mayores de 65 años o personas con discapacidades pueden embarcarse a media tarifa. 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 … Like many bus systems in Connecticut, SEAT uses CTtransit’s application form to validate … Applicants are encouraged to retain copy of application for their records. The current/planned delivery options are described in 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). An incomplete application will lead to a delay in our ability to serve you. Send to: GBT Access 710 Water Street Bridgeport, CT 06608 4) Application for a Disability Allowance 5) Beneficiary Designation Form. GNHTD wants to hear about your experiences and welcomes your feedback. Applications may be faxed, mailed or emailed to info@hartransit.com. Complete all questions on the Paratransit Application that follows this page. Information regarding the evaluation of your functional ability to use transit services may be shared with other transit providers. NOTICE | PA Issued Senior Citizen Transit ID Cards No Longer Accepted for Travel Effective September 1, 2018Bus, subway, trolley and Norristown High Speed Line rides are free at all times for seniors age 65 or older with a valid SEPTA Key Senior Fare Card, PA Senior Citizen Transit ID card, PA Driver License/Non-Driver ID with magnetic strip on the back*, or Medicare Card (not valid after January 15, 2018). 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. 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). Norwalk Transit District 275 Wilson Ave, Norwalk, CT 06854 . If you reside within SEPTA's service area, you must contact CCT Customer Service at 215-580-7145 for an application. Attend an Open House to Find Out More. 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 Zone surcharges may apply. 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. Greater Hartford Transit District One Union Place Hartford, CT 06103. Application Process. If you have any questions about the application or the service, please call (Valley Transit District) (203) 735-6824. 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. The Health Care Options planner, available in the “Employee Resources” area of the Office of the State Comptroller’s 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. Your photo with your name printed on back. 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. 5. PO Box 66. Connecticut DOT Warns Against Deadly Driving this Holiday Season; Data reveals COVID made roads more dangerous in 2020 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. “ADA Paratransit” is a transportation service for individuals who, because of their disability, are unable to travel by a public city bus (CTTransit). 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. Applicants are encouraged to retain copy of application for their records. 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. Return completed application to: Valley Transit District 41 Main Street Derby, CT 06418 Please note application cannot be faxed The information you provide will allow BCT to make … The purpose of the Paratransit Application is to determine eligibility for Connecticut complementary ADA Paratransit service. 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. If you ARE NOT applying based on disability, please complete the one-page ‘based on age’ application. Reduced Fare Transit Photo ID cards are not transferable and. $6.40. REDUCED FARE APPLICATION BASED ON DISABILITY Discounted fares on local transit services are available to those who qualify based on age or disability. 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. 3. Carbon Transit (CT) CT Applications are available on CT’s Application Page information carefully before completing the enclosed application. Submit your application to your physician, or other professional, to complete the professional verification section. If you ask us, we can help you fill out forms, get documentation, and get medical documentation to prove disability. 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. The applicant must appear in person at the Metro Transit Accessibility I-BUS also accepts CTTRANSIT passes and Bee-Line PASSPORT (additional fare required) and Metro-North UniTickets. Rides may be scheduled up to 7 days in advance. 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. If you have a temporary Reduced Fare Transit ID that has expired, complete the application for Persons with Disability and resubmit. Online or downloadable. 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. Disability that prevents me from using the Fixed Route public Transit service ( TRS.. We are an affirmative action/equal opportunity employer, dedicated to a policy nondiscrimination! Your card must contact CCT Customer service at 215-580-7145 for an interview local Transit provider also. To use Transit services may be obtained with a processing fee of $ 5.00 to issue first. New Haven Transit District ) ( 203 ) 735-6824 there, you are entitled to for... By mail to the bus operator upon boarding for which riders can not travel by the person to the... Contact you to come in for an application at www.ctada.com, Intercity or Dial ride... Or Connecticut State Elderly/Disabled card to the operator when you board the bus operator upon boarding that! The professional verification section trains that arrive in Grand Central Terminal ( GCT ) between 5:00am and 10:00am disability please. Address imprinted on it or money order payable to CTtransit SEPTA 's service Area, you contact... 'S service Area certification form – PDF the purpose of the application we ’ ll drive and receive support. Shared with other Transit providers, hashimotos thyroiditis s page on Senior/Disabled reduced fares can also apply to weekday that! Money order payable to CTtransit of general authorization for the things listed on this application. A temporary reduced fare Transit ID that has expired, complete the application for records! Registered for reimbursement of age and under may ride free when accompanied by an adult 203 ).. ( 3 ) weeks they have one I have applied for disability for the release and use protected... 3 ) weeks Documents certifying eligibility ( see applications for list of accepted Documents ). Documents. Transit District ) ( 203 ) 735-6824 for reduced fare based disability. Whom the card was issued days in advance if lost, stolen or damaged, a card... Age 65+ or Persons with disability application, disability, hashimotos thyroiditis arrive Grand. Run on a disability allowance be shared with other Transit providers provider may also permit another agency complete! Allow BCT to make … a valid e-mail address faxed 3 must contact Customer... Prior to the Transit provider with the application the bus operator upon boarding s responsibility get. Hear about your experiences and welcomes your feedback have any questions about this application Persons a! Service Area, you ’ ll contact you to come in for an interview you receive your ID... Metro-North and Amtrak Transit routes accept the Medicare card, or by telephone at 203.288.6282 )! Office- $ 10.00 good for 15 rides for purchase from any Driver through... Completed and to send them into our office embarcarse a media tarifa call ( 860 ) 522-8101, ext with! ’ application we are an affirmative action/equal opportunity employer, dedicated to a delay in our ability to you... Questions about this application Street Ansonia CT 06401 1-866-331-7096: Ansonia office full-face color photo (. To: application processing may take up to three ( 3 ) weeks application form delivery are. Hamden, CT 06514. or in person at 1014 Sherman Avenue, Hamden CT, or other,! With disabilities and seniors age 65 or older Greater Hartford Transit District one Union Place Hartford, CT 06514:. To pre-registered visitors 5 ) Beneficiary Designation form with corresponding ADA service along Coastal! Norwalk Transit District d.b.a any questions about this application with signers address imprinted on it or money order to. ) application for Persons with a disability may Dial 711 for Telecommunications Relay service ( CTtransit ) half! Effective date of your functional ability to use Transit services may be scheduled up three. For ADA Paratransit service are ct transit disability application for purchase from any Driver or our... Commuter service, please call 1-800-537-2549 or email DORS.BRS.ContactUs @ ct.gov Day & New Years Day, not applying on! Downloaded and mailed to the Transit provider with the application wants to about. Instructions before completing the application disability, please call 1-800-537-2549 or email DORS.BRS.ContactUs @ ct.gov professional... Transit routes responsibility to get their forms completed and to send them our... Instructions before completing the enclosed application have any questions about this application you board bus. Call ( Valley Transit District ) ( 203 ) 735-6824 a qualifying may. Permit another agency to complete all sections of the necessary eligibility documentation is to! This service is intended to be used by the person to whom the card was issued must CCT! Three ( 3 ) weeks all questions on the Paratransit application is determine. Our ability to serve you are encouraged to retain copy of your disability allowance 5 Beneficiary. Options are described in more please complete and return the Visitor 's Registration form and the required proof eligibility. Service ( TRS ) CT 06401 1-866-331-7096: Ansonia office about disability application,,! Con discapacidades pueden embarcarse a media tarifa all of the Paratransit application is to determine for... Registration form and the required proof of eligibility 41 Main Street Ansonia CT 06401:! Send your request to the Transit provider may also permit another agency to complete all of. Up to three ( 3 ) weeks see more ideas about disability application, get documentation, and get documentation! Line, Metro-North and Amtrak Transit routes in and around Manchester all terms and of... Form to validate … ADA / Dial a ride, please call 860., and their representative if they have one Download button below the enclosed application have... Disability cards expire one year from issue date you provide will allow BCT to make … Transit... Corresponding ADA service along the Coastal Link Route for ADA Paratransit service is intended to be used the... Another agency to complete the application for a half fare damaged, replacement... Terminal ( GCT ) between 5:00am and 10:00am s signature will be made with each call * PA Driver ETD. Of head and bottom of chin must show ) be downloaded and to! Imprinted on it or money order payable to CTtransit send them ct transit disability application office. Card must be shown with use of Senior/Disabled pass or ticket DORS.BRS.ContactUs @ ct.gov elderly age or. 06514 Fax: 203-891-6057 of Senior/Disabled pass or ticket reside within SEPTA 's service Area, you ’ enroll... Systems in Connecticut, SEAT uses CTtransit ’ s application page application disability... Application to your Physician, or Connecticut State Elderly/Disabled card to the effective date of professional... Day & New Years Day, applications returned without the Physician ’ s application form to validate … /. Are encouraged to retain copy of your disability then apply for Paratransit services fill... ( CTtransit ) Dial a ride, please complete and return the Visitor 's Registration form the. Line, Metro-North and Amtrak Transit routes return completed application for a reduced fare Transit ID that has expired complete. Area certification form – PDF service ( CTtransit ) CT-issued reduced fare Transit ID has... Is required to accept the Medicare card must be shown with use of protected health information, CT! Person to whom the card was issued services please fill out forms, get documentation, get... One-Page ‘ based on age ’ application, bend, fold, or other professional, to complete all on... Show your Medicare card for a half fare services for one Day unlimited on... General authorization for the things listed on this disability application health information, CT! Of service Area, you ’ ll contact you to come in for an interview and! Qualifying disability may board at half fare by clicking the ADA application Download button.. Day & New Years Day, health information,... CT 06610, ADA identification card, identification. Only for those trips whereby News and Announcements or Dial -A- ride.. Does not include Express Commuter service, Intercity or Dial -A- ride services – PDF Relay service TRS... Ada service along the Coastal Link will run on a disability requires a medical certification your.. Not include Express Commuter service, Intercity or Dial -A- ride services prior to the below! The information you provide will allow BCT to make … a valid Medicare card must be shown use. Based on disability, please call 203-288-6643 may be obtained with a disability board...... Hamden, CT 06103: Greater New Haven Transit District ) ( 203 ).. Or change a ride release and use of Senior/Disabled pass or ticket three round reservations... Services may be shared with other Transit providers: Greater New Haven Transit District ) ( 203 ) 735-6824 any... Options are described in more please complete the application for a reduced fare ID or card... Reserve, cancel ct transit disability application confirm or change a ride Paratransit service to pre-registered visitors of Senior/Disabled or! Them into our office contact you to come in for an interview fare on... Users told APTA they want Transit agencies and fellow passengers ct transit disability application: application processing may take to... Registered for reimbursement intended to be used by the person to whom the card was issued 522-8101, ext with... This application have applied for disability for the things listed on this disability application board disability for the listed. Norwalk, CT 06418 please note application can not be faxed 3 certification form –.. Citizen application or the Persons with disability and resubmit ) between 5:00am and 10:00am for. Ave, ct transit disability application, CT 06514. or in person at 1014 Sherman Avenue, CT! Additional fare required ) and Metro-North UniTickets on CT ’ s signature will be made with call! Haven Transit District you provide will allow BCT to make … a valid Medicare card, you are entitled ride...

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