Metro Mobility Professional Verification Form, MN

Metro Mobility is the ADA paratransit service in the Twin Cities. Every application needs two parts: the applicant's Certification Questionnaire and the Professional Verification Form, completed by a professional familiar with the applicant's condition. Metro Mobility uses the verification to judge whether a disability prevents boarding, riding or reaching regular buses and light rail.

Who completes it

The applicant completes the Certification Questionnaire and Section A, an authorization to release information. A physician, psychiatrist, psychologist, therapist, RN, chiropractor, LISW or LICSW, certified orientation and mobility specialist, or rehabilitation counselor completes and signs Section B.

Submitting and payment

How to submit it
The professional returns the form to the applicant, who sends both parts together in one envelope, or by fax or email, to the Metro Mobility Service Center. Parts that arrive separately are not processed.
Who pays
The packet does not address payment for completing the Professional Verification Form.

Good to know

  • The form must be signed with credentials. Metro Mobility's own example: 'Jane Doe' is incomplete, while 'Jane Doe M.D.' is complete.
  • Section B lists all diagnoses, including ones the professional is aware of but not treating, with onset, last visit, medications, therapy and an estimate of recovery time if temporary.
  • Optional sections cover cognitive testing (IQ, MMSE, WAIS), psychiatric symptoms, seizures in the last six months, head injuries and corrected visual acuity and fields.
  • Incomplete applications are returned once; a second incomplete submission is held 60 days, then discarded. Standard certification lasts four years.

Get the official form

Download the current version from the source each time; forms change without notice.

Metro Mobility Application Form - Professional Verification Form

Fill it with Vero

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.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can complete the Metro Mobility Professional Verification Form?

Physicians or psychiatrists, occupational, physical and recreational therapists, psychologists, LISW or LICSW social workers, speech-language pathologists, certified orientation and mobility specialists, registered nurses, chiropractors, certified rehabilitation counselors and vocational rehabilitation counselors who are familiar with the applicant's condition.

How long does Metro Mobility take to decide?

Metro Mobility decides within 21 days of a complete application, and if it does not, the applicant is eligible until certification is finished. When more information is needed, an in-person assessment may include a FACTS cognitive test and a Tinetti gait and balance test, with a decision 21 days after it.

What should a professional avoid considering on the Metro Mobility form?

The letter to professionals says to consider only the presence of a disability, not the applicant's age, economic status or proximity to transit. Eligibility rests on whether the disability prevents boarding, riding or getting to regular buses and light rail.