TriMet's Honored Citizen Application gives riders with a permanent or temporary disability a photo ID card for the reduced Honored Citizen fare in the Portland area. When the applicant has no Medicare card, Social Security verification or other qualifying proof, a health care provider completes the certification on the back. The applicant then submits the form in person, where TriMet takes the photo.
The applicant completes the front and signs a release naming the provider who may verify the disability. On the reverse, a physician, physician assistant, licensed clinical social worker, certified alcohol and drug counselor, QMHP or registered nurse practitioner records a license or certification number and certifies the disability.
Download the current version from the source each time; forms change without notice.
Honored Citizen Application - Health Care Provider Certification Section
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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The form lists physicians, physician assistants, licensed clinical social workers, certified alcohol and drug counselors (CADC), qualified mental health professionals (QMHP) and registered nurse practitioners. The provider certifies having examined the patient and that the disability substantially limits one or more major life functions, and TriMet may contact the provider to verify.
The application must reach TriMet within 30 days of the date the health care provider completed the certification section. After that the provider section is out of date and the patient needs a new one, so the patient should plan the in-person visit for the photo soon after the appointment.
No. TriMet will not accept a photocopy, fax or email of the form, and the application must be completed by hand. First-time and renewal applicants submit it in person with a government-issued photo ID because TriMet takes the photo for the card at that visit.