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Town of Truckee DAR Application

What is a Paratransit Eligibility Program?

The Americans with Disabilities Act (ADA) requires transit agencies to provide priority paratransit services to people with disabilities who cannot use the fixed route bus. The Town of Truckee Paratransit Eligibility Program is a process to determine ADA capacity. Eligibility is based on a rider’s ability to use accessible buses in Truckee. It is not based solely on disability, age or medical diagnosis. It is based on the person’s ability.

Can the person, without the help of anyone:

  • Get to and from the bus?
  •  Get on and off the bus?
  • Understand which bus to get on and when to get off the bus?

An ADA certified person who requests their ride by 5:00 P.M. the day in advance will receive priority scheduling over persons with no ADA eligibility. This priority rating will also be valid with similar services offered by other transit agencies.

Americans with Disability Act (ADA) Eligibility Program

The Town of Truckee contracts with a transit operator to provide transit services within the Town. One of those services is a Demand Response service referred to as “Dial-A-Ride”. The Americans with Disabilities Act (ADA) paratransit service is a specialized priority transportation service for persons who are unable to independently use fixed route bus service due to a disability or health related condition some or all of the time. This specialized priority paratransit service is provided by the Town of Truckee as part of the federal requirements of the Americans with Disabilities Act.

How to Begin the Paratransit Eligibility Application Process

Request an ADA Paratransit Eligibility Informational Booklet (this publication) by calling the Town of Truckee Transit Division at 582-2489. The booklet includes an application for a rider interested in ADA eligibility to
complete and sign.

The Town of Truckee along with the transit operator will review the application and may call the applicant for any clarification needed. An eligibility determination will be reached and a notice of eligibility will be mailed along with a Paratransit Eligibility Card within 21 days of receipt of a COMPLETED application. In the case that no eligibility criteria has been met and if the applicant wishes, an appeal can be sent to the Town of Truckee. Information on the appeal process will be included in the notice of eligibility. In order to be placed as a priority for ADA paratransit services (Dial-A-Ride), you must first be certified as eligible. Please read the following instructions before filling out the attached application form. All information that you supply will be kept strictly confidential.

Your application may require additional information, such as a phone call, personal interview, assessment with you, or consultation with your doctor or therapist. Eligibility is not based on age, economic condition, or inability to drive an automobile. Interested applicants should note that having a medical condition or a disability will not automatically qualify them for ADA paratransit eligibility.

Please FULLY answer all of the questions in this application and return it by mail to:

Town of Truckee Transit Division
10183 Truckee Airport Road
Truckee, CA 96161

Request for Certification of Americans with Disability Act Paratransit Eligibility

The information obtained in this certification process will only be used by the Town of Truckee for the provision of transportation services. Information regarding the evaluation of your functional ability to use transit services will only be shared with other transit providers to facilitate travel in those areas. The information will not be provided to any other person or agency.

Name: ______________________________________________________________________________________

Address: _______________________________________________________________________________

Mailing (if different than above): _______________________________________________________________________________

Phone: Home ______________________
Cell ________________________
Alternate ____________________

 

  1.  What is the disability which prevents you from using our fixed route bus service?
    ___________________________________________________________________________________
  2. Is this condition temporary?          YES                NO If yes, when is it expected to subside? ______ /______ /______
  3. How does this disability prevent you from using fixed route bus services? Please explain completely. Use an additional sheet, if necessary.__________________________________________________________________________________________________
  4. Are there any other effects of your disability of which we need to be aware?
    The following information will be used to ensure that an appropriate vehicle is used to provide your transportation and so an accurate analysis of your trip requests can be made by TART.__________________________________________________________________________________________________
  5. Do you use any of the following mobility aids? (check all that apply)Manual wheelchair ______
    Electric wheelchair ______
    Wheelchair ______
    Cane ______
    Guide dog ______
    Other service animal ______
    Crutches ______
    Powered scooter ______
    Personal care attendant ______
    If you use a wheelchair or scooter, what is it’s:
    length ______ inches           width ______ inches
  6. Does the total weight of your wheelchair or scooter and yourself exceed 600 Lbs.?
    YES                NO*Please note that we may not be able to accommodate wheelchairs or scooters that
    exceed these specifications when occupied: 48 inches in length- 32 inches in width, 600
    pounds (including the individual.
  7. Do you currently use any transit or paratransit service in the region?
    YES                NOIf yes, please describe: __________________________________________________________________________________________________
  8. What is the maximum distance you can travel without the assistance of another person?       ______  yards
  9. Does your disability prevent you from traveling this distance in snow, ice or over certain terrain? (Explain)
    ______________________________________________________________________________
  10. Can you climb up and down three 12-inch steps to get on and off a bus?   YES                NO               SOMETIMES
  11. What is the maximum period of time you can wait outside without support?
    ______________________________________________________________________
    ______________________________________________________________________
  12. Is this time period affected by extremes of hot or cold weather?
    YES                NO
    If yes, please describe: ___________________________________________________________________________
  13. I hereby certify that the information given above is correct.
    Signed: ___________________________________________________________________________
    Dated:  ______ /______ /_____
  14. If this application has been completed by someone other that the person requesting certification, that person must also complete the following:
    Name: __________________________________________________________________________
    Address: ____________________________________________________________________________________
    Phone: _________________________Home: ______________________________ Alternate: ___________________________________
  1. Signed: _______________________________________________________________________________
    Dated:  ______ /______ /______

    Authorization to release personal information
    (To be completed by applicant. A doctor’s statement is not required.)

    I hereby authorize the release of information to Tahoe Area Regional Transit about my functional travel abilities. The information released will be used solely to determine my eligibility for ADA paratransit service.

    Name of professional*: ___________________________________________________________________________________________________________

    Agency/Organization:  ___________________________________________________________________________________________________________

    Phone number:  _________________________________________________________________________________

    I understand that I have the right to receive a copy of this authorization. I understand that I may revoke this authorization at any time.

    Name of applicant (please print):  __________________________________________________________________________________________________

    Signature of applicant ________________________________Date _______________________________________________________________________

    *Verifying “professional” may be a rehabilitation specialist, disability evaluator, mental
    health case worker, physician or other such individual knowledgeable of your disability
    or disabilities and functional travel abilities.

     

Return completed application to:
Town of Truckee Transit Division
10183 Truckee Airport Road
Truckee, CA 96161
e-mail: [email protected]
Telephone (530) 582-2489