TDOT Transit ADA Application Request

Eligibility Specialist Blanca Valenzuela* Secretary Melissa Morris Contact (520) 791-5409 Phone
(520) 791-5453 Fax
(520) 791-5452 TDD/TTY

* Se Habla Español

Committed to keeping Tucson on the go.

Transit Division - ADA Office

ADA Paratransit Eligibility Application Request

Please enter your name, address and telephone number. Your E-mail address is optional. Click the "Submit Form" button when you are ready to send the form, and a ADA Paratransit Eligibility Certification Request Form will be mailed to you as soon as possible. Use the "Reset" button if you want to clear the information in the form and start over. Thank you for your interest in the ADA Paratransit Eligibility program.

First Name:	Last Name:
Address:

Date of Birth:
City:	State:	Zip:
Phone Number:	Email (Optional):

Department of Transportation

Director Jim Glock, P.E.

Transit Division - ADA Office

ADA Paratransit Eligibility Application Request