Access-a-Ride Medical Verification Form
Instructions for Medical Providers
- Download and print the form below titled "Access-a-Ride Medical Verification Form 2023"
- Medical provider to fill out all sections and sign the form.
- Remind the applicant that the Customer Application for Paratransit must also be submitted before their documents will be processed.
Health care providers who can complete this form (must be treating the disability for which applicant is applying for paratransit service):
- Physician
- Psychiatrist
- Respiratory Therapist
- Optometrist
- Chiropractor
- PT/PTA
- OT/COTA
- SLP
- Social Worker
- Mental Health Clinician
- Rehabilitation Counselor
- Orientation & Mobility Specialist
- Registered Nurse
- PA / NP
- Psychologist
- Ophthalmologist
Submit the Medical Verification Form
Fax the completed form to 303-299-2169
or mail to RTD c/o Access-a-Ride 1660 Blake Street, Denver, CO 80202
Please include the applicant's name on all pages.
RTD DOES NOT ACCEPT PHOTOS OF ANY DOCUMENTS.
Medical Verification Form
More Information
Access-a-Ride Application for New Customers
Information about applying for Access-a-Ride services as a new customer
Apply for Access-a-Ride as a new customerAccess-a-Ride Application for Current Customers
Information about applying for Access-a-Ride via paper application
Re-apply for Access-a-Ride