Forms and References

Transportation Program Model 2017 (29.27 KB)

Surplus Ticket Tracker

Surplus Ticket Tracker Response

Medicaid Transportation Instructions to Consumer (438.13 KB)

Instructions to Identify Transportation Benefits in Oregon Access (514.47 KB)

2017 Guide To Medicaid Transportation Options (64.5 KB)

2017 Guide to Medicaid Transportation - Short Version (18.63 KB)

Transportation Fare Assistance Assessment - Word doc (89.99 KB)

Transportation Fare Assistance Assessment (2.37 MB)

Instructions to Open and Save PDF Fare Assessment Document (215.66 KB)

WiseGuide Instructions - Premium Rides (817.11 KB)

ADRC Transportation Taxonomy Terms (72.46 KB)

TriMet Ticket Pass Order Form (31.45 KB)

30 day Notice of Reduction or Elimination of Services (13.77 KB)

Notice of placement on underserved or waitlist (13.83 KB)

Waiver Guidelines Request (17.12 KB)

UCR - Add/View Notes Instructions (518.36 KB)

Transportation Program Letter for consumers

Transportation Program Letter 2016 (Amharic) (17.54 KB)

Transportation Program Letter 2016 (Arabic) (18.29 KB)

Transportation Program Letter 2016 (English) (17.88 KB)

Transportation Program Letter 2016 (Farsi) (16.39 KB)

Transportation Program Letter 2016 (Korean) (17.72 KB)

Transportation Program Letter 2016 (Oromo) (16.98 KB)

Transportation Program Letter 2016 (Russian) (17.64 KB)

Transportation Program Letter 2016 (Simplified Chinese) (16.58 KB)

Transportation Program Letter 2016 (Somali) (18.58 KB)

Transportation Program Letter 2016 (Spanish) (15.41 KB)

Transportation Program Letter 2016 (Traditional Chinese) (17.09 KB)

Transportation Program Letter 2016 (Vietnamese) (20.24 KB)

Transportation Program Notice of changes to Fare Assistance Program 

Transportation Program Notice (English) (13.89 KB)

Transportation Program Notice (Amharic) (17.78 KB)

Transportation Program Notice (Farsi) (680.77 KB)

Transportation Program Notice (Oromo) (15.13 KB)

Transportation Program Notice (Russian) (15.93 KB)

Transportation Program Notice (Simplified Chinese) (15.65 KB)

Transportation Program Notice (Somali) (16.17 KB)

Transportation Program Notice (Traditional Chinese) (17.59 KB)

Transportation Program Notice (Vietnamese) (15.29 KB)