Transportation

You may reserve our transportation services by answering the following questions. For reservations less than 90 minutes from now, please call us at 305-418-0326 instead.

Patient / Pickup Information

Patient first name:
Patient last name:
Patient date of birth:
Pick-up date:
Pick-up time:
Appointment time:
Pick-up address:
Pick-up city / ZIP: , FL
Pick-up point
(e.g. Side Door, West Entrance):

Destination Information

Destination address:
Destination city / ZIP: , FL
Destination drop-off point
(e.g. Front Door, Back Entrance):
Transportation type / Return required: Transportation Type: Return Required?: Out-of-County Transport? ($2.50 per mile)
Patient weight:
Additional comments:

Contact Details

Full Name:
Contact Phone Number:
Contact Fax Number:
Contact Email:

Save the trip?

You can save this trip info if you plan on booking the same reservation again in the future. If this is a previously saved trip you do not need to resave it.

Save this reservation's details
for future use?

Name this reservation: