5081 Fred Wilson El Paso, TX 79906
(915) 212-LIFT (5438)
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Sun Metro LIFT provides door-to-door transportation service on a shared-ride basis using small buses equipped with hydraulic wheelchair lifts. This service is available to persons who because of their disability, are prevented from:
Category 1 – Independently getting to/from a bus stop or transfer point using traditional Sun Metro fixed – route buses.
Category 2 – Independently boarding, riding and exiting a Sun Metro fixed-route bus.
Category 3 – Boarding or getting to/from a bus stop because of the inability of the bus to deploy the lift or ramp at an inaccessible bus stop.
Please complete this application to the best of your ability, and as thoroughly as possible. If there are any questions that you do not understand, please call Sun Metro LIFT at (915) 212-LIFT (5438) for further assistance. In order for your application to be considered complete, all questions, including the Certified Doctors/Medical Verification form, must be answered, the application will not be processed until completed.
The application aims to provide a fair opportunity for you to describe barriers in the environment and how your disability prevents you from using Sun Metro LIFT paratransit transportation service. The more information provided, the better Sun Metro LIFT will understand your ability and travel challenges. Information contained in this application will be kept confidential and shared only with professionals involved in evaluating your eligibility status to utilize Sun Metro LIFT.
Important: All Sun Metro LIFT applications must be processed within 21 days of receiving a completed application to include Medical Verification Form. At times, Sun Metro LIFT may request phone interview and/ or an In-Person Functional Assessment to obtain more information regarding your application. Sun Metro LIFT will provide transportation for an In-Person Functional Assessment to our office at 5081 Fred Wilson, Ave. During this time, you may provide any additional information pertaining to your application that you may deem necessary.
Full Name
Address
Date of Birth
Gender
Would you prefer to receive future written information in an alternative format? Please mark the desired format.
Contact #1
Contact #2
Do you have a disability that prevents you from using the Sun Metro fixed route? (The fixed-route system consists of the regular Sun Metro large buses)
Is your disability or disabilities a permanent or temporary condition?
Do you have a visual impairment?
Your vision is worse during these conditions:
Does wearing corrective glasses help under these conditions?
Your eye condition is considered to be:
While boarding a bus, you can see:
Can you see and identify bus stop and route information?
Can you see and identify your bus drop-off location?
Can you cross a street without assistance?
Can you safely navigate to your bus at a fixed-route transit center?
If a transfer is required in your route, can you see and identify which bus stop you must exit?
Can you see and read a map?
Can you read small font on the Sun Metro bus schedules?
Do you have a hearing impairment?
Are you able to travel independently after dark?
Are you able to independently locate an audible cross walk indicator and successfully cross an intersection?
Are you able to independently navigate through a fixed route terminal and locate your desired bus stop?
Do you currently take any medication?
Do weather conditions affect your disability? If so, please explain how:
Do you use a mobility device? Please mark all that apply:
Do you require assistance to/from the front door of your home?
Do you require a Personal Care Attendant?
Are you currently able to utilize the fixed-route system?
Are there times when you would be able to use it?
Do you think with enough training that you would be able to utilize the fixed-route?
If you utilize the fixed-route system, how often do you utilize the service?
Are you able to independently and without assistance walk up to ¼ mile (about 4 blocks)?
Are you able to wait outside without assistance or support for up to ten minutes?
Do you have the ability to recognize landmarks of your destination without assistance?
Do you have the ability to deal with unexpected changes in your route?
Have you ever gotten lost while traveling alone?
If you answered yes, were you able to find your way back?
Do you utilize a smart phone, and, if so, are you able to contact Sun Metro for assistance with route information?
Would you be interested in learning how to utilize the fixed route through Travel Training with a certified trainer? This program is free of charge.
Should we have further questions regarding your application, do you authorize Sun Metro LIFT to contact your Doctor and/or Certified Agency for further questions?
List the top three (3) locations that you often travel to with your current mode(s) of transportation.
Your answers to the following questions will help Sun Metro LIFT better understand your functional ability in specific areas. For each question, please check one answer. Your answer should be based on whether you can perform this activity independently without assistance.
Can you use the telephone to call Sun Metro for route information and schedules?
Can you walk up and down three steps if there are handrails?
Can you walk up or down a gradual hill on the sidewalk, if the weather is good?
Can you find your own way to the bus stop if someone shows you the way once?
Can you walk up to one city block without taking a rest break?
Can you wait ten minutes at a bus stop that has no shelter or bench?
Can you cross a controlled intersection within the allotted time provided?
Can you travel alone?
Can you transfer from one fixed-route bus to another fixed-route bus?
Can you navigate through a fixed route terminal independently?
Can you verify and pay the correct fare?
Can you keep track of time?
Can you provide personal information (i.e., phone number, name, address)?
Did you require assistance in completing this application?
An additional form is required. The Paratransit Verification Form which is to be filled out by your doctor (follow instructions on Sun Metro LIFT Eligibility page) or a certified Sun Metro LIFT Representative. Please select below if you would like your doctor or a LIFT representative to fill out the form.
Who do you want to fill out the Paratransit Verification Form?
Important: Sun Metro LIFT will only use this information to determine your eligibility to use Sun Metro LIFT. Sun Metro LIFT will keep this information confidential and secure and will only use it for transportation-related purposes. Sun Metro LIFT may also use the contact information provided to solicit feedback about the LIFT, including providing the telephone and name to a third party to carry out periodic surveys.
Your Signature