Required fields are marked with asterisks (*)

Application for Specialized Transit

Overview

In order to be eligible for Specialized Transit, all users must first submit an application form which will be reviewed by Niagara Region Transit, against the approved Eligibility Criteria. If your application is incomplete, it will be returned to you or you may be contacted for more information. You will be notified of your eligibility by email or mail.

If approved, you will be eligible to book trips on all specialized transit services in Niagara; Fort Erie (FAST), Niagara Falls (Chair-a-van), Niagara Specialized Transit (NST), St. Catharines (Paratransit), and Welland (WellTrans).

If denied, all Niagara Region Transit buses are fully accessible.

Please complete Part 1 in full and have your Health Care Provider fill out Part 2. Please ensure the entire form is completed legibly.

If you have trouble completing your form, please don’t hesitate to contact us at 1-833-NRT-LINE (1-833-678-5463).

Specialized Transit is considered a shared ride service. A shared ride service means:
• Other riders may be on board during the trip to your destination
• Your route of travel may be altered so another rider(s) can be accommodated
• You may be on board for up to 75 minutes
• The vehicle may stop and pick up other riders as it travels to your destination

Eligibility Guidelines

Persons wishing to use specialized transit must have a disability that prevents them from using conventional transit.

Disability alone does not constitute eligibility. Decisions are made on a case-by-case basis and are based on the applicant’s functional ability to use conventional transit some of all of the time. It’s not a medical decision deemed by the applicant’s physician. It is also not based on the applicant’s income, age, or lack of conventional transit in their area.

Steps to enrol in Niagara Specialized Transit

If you are the applicant

Option 1
- Complete and submit Part 1 below
- Print Part 2, have it completed by a medical/health care professional
- Email Part 2 to applications@nrtransit.ca
Option 2
- Print Part 2 to be completed by a medical/health care professional
- Scan and save Part 2
- Complete Part 1 below and attach Part 2
- Click Submit
Option 3
- Print Application
- Complete Part 1
- Have a medical/health care professional complete Part 2
- Scan and email completed application to applications@nrtransit.ca

If you are a medical/health care professional completing this form below on behalf of the applicant:

Complete Part 1 on behalf of the applicant and click submit
Part 2 will open, once complete click submit.

A representative from Niagara Region Transit will be in contact once we have received all documentation. Please be advised that we are experiencing delays in processing applications to specialized transit services. Applications will take 10-15 business days to be completed. If you require immediate assistance, please call us directly at 1-833-NRT-LINE (678-5463), and press option 2, and then option 1 when prompted.

Part 1: Personal Information

To be completed by the applicant or their designate

Last Name

First Name

Street Number

Street Name

Street Suffix

Apartment / Unit Number

City/Town

Postal Code

P.O. Box

Phone Number (xxx-xxx-xxxx)

Phone Number (Alternate) (xxx-xxx-xxxx)

Date of Birth

Long-term care facility

What is your gender? Gender refers to current gender which with may be different from sex assigned at birth and may be different from what is indicated on legal documents. (Select all that apply).

Woman/Girl - people who identify their gender as such, regardless of sex assigned at birth

Man/Boy - people who identify their gender as such, regardless of sex assigned at birth

Non-binary - an umbrella term referring to people who do not identify with the gender binary of woman/man, and can include gender fluid, gender-queer, androgynous

Trans woman - a person whose sex assigned at birth is male and identifies as a woman

Trans man - a person whose sex assigned at birth is female and identifies as a man

Not listed

Do not know

Prefer not to answer

Emergency Contact Information

First Name

Last Name

Relationship to applicant

Phone Number (xxx-xxx-xxxx)

Designate Information

I would prefer all communications be sent to a designate

Disability Information

Note: Unavailability of conventional transit does not constitute eligibility for specialized transit.

Please describe any circumstances or factors which prevent you from using conventional fixed route transit services (environmental/health/weather concerns/physical limitations, etc.)

Authorization

I hereby certify that the information provided in Part 1 is, to the best of my knowledge, true and accurate and I authorize Niagara Region Transit to use this application to assess my eligibility. I also authorize the signing medical / health care professional to release the information requested in Section 2 to the Niagara Region Transit Commission for purposes of determining eligibility. I authorize Niagara Region to disclose required information to other transit services in order to support the use of other specialized transit services. If applicable, I acknowledge that I must carry my Universal Support Person Pass with me, otherwise my accompanying Support Person will be required to pay a fare.

Authorization

I am an authorized medical / health care professional at a Niagara Region long-term care facility or a recognized dialysis clinic filling in this form on behalf of the applicant

Do you have a completed Part 2: Health Care Professional application you can attach?

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Personal Information and Privacy

Any personal information or personal health information is collected, used and disclosed by Niagara Region under the authority of the Municipal Act for the administration of the inter-municipal transit service in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Questions should be referred to the Access and Privacy Office at 905-980-6000, ext. 3779 or FOI@niagararegion.ca.