Medical Transportation Assistance Request

• Completed application form
• Applicant signature authorizing release of medical information
• Medical provider details and assessment

Who is eligible?

• Ontario Works members

Eligible expenses

• Medical transportation costs covered through the benefit

Ineligible Costs and Activities

• Transportation by bus when the medical condition does not make it impossible or impractical

Eligible geographic areas

• Kingston, Ontario

• Medical condition and appointment needs must be described by the health care professional.
• Frequency of appointments must be specified.
• Ability to use bus transportation must be assessed.
• Suitable transportation methods must be indicated.

• Step 1: Complete the member section
  • Fill in personal details on the form.
  • Sign the authorization to release information.
• Step 2: Have the health care provider complete the medical section
  • The provider describes the condition and appointment needs.
  • The provider confirms whether bus transportation can be used.
• Step 3: Submit the original form
  • Take the completed form to the health care provider.
  • Provide the original documents as required.

• The form is completed by the Ontario Works member and a health care professional.
• The information is collected to administer Ontario social assistance programs.
• Only original documents are accepted.