Please fill out the form below with all required information to schedule your non-emergent transportation. Ensure each field is completed accurately to help us provide you with the best possible service. This form does not establish or confirm a ride appointment. For Medicaid questions or additional information, please contact the Medicaid Central Call Center at 1-866-614-6005 email us at [email protected] or fill out the form below and we’ll get back to you within two business days.
