Hamilton's Accessible Transportation Services publishes this version of its application for people living in long-term care homes, whose care needs include 24-hour nursing and personal care, help with daily activities and on-site supervision. It leads to DARTS door-to-door shared rides and Taxi Scrip. A health care professional, including a registered practical nurse, completes Part 2 on function, safety and support needs.
The resident or their representative or substitute decision-maker completes Parts 1A to 1E and the optional Part 3. Parts 2A and 2B are completed by a physician, nurse practitioner, registered nurse, registered practical nurse, chiropractor, physiotherapist, occupational therapist or regulated MSW.
Download the current version from the source each time; forms change without notice.
ATS Application Form - Residents of Long-Term Care
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This version, for applicants who live in long-term care as defined by Ontario's Long-Term Care Homes Act, 2007, with needs such as 24-hour nursing and personal care. Anyone not living in long-term care completes the general Accessible Transportation Services application instead.
Yes, but only on this long-term care version. Parts 2A and 2B list physicians, nurse practitioners, registered nurses, registered practical nurses for long-term care residents, chiropractors, physiotherapists, occupational therapists and regulated MSWs. The professional signs, stamps and adds a registration number.
Functional limitations and how they compromise use of HSR buses, with onset, staging and prognosis; mobility device; permanent, temporary or seasonal need; stairs, walking distance and waiting up to an hour; behaviours affecting safety; wandering or getting lost; support person needs on DARTS; and any service animal.