Virginia non emergency transportation log 2025

1. Click ‘Get Form’ to open the Virginia Non-Emergency Transportation Log in the editor.
2. Begin by entering the Provider Name and ID at the top of the form. This identifies your service provider.
3. Fill in the WEEK ENDING date, which indicates the week for which you are logging transportation services.
4. Input the Driver's Name as it appears on their driver's license, ensuring accuracy for verification purposes.
5. Document each trip by entering details such as Date of Service, Member's Name, and LogistiCare Job Number.
6. Record pick-up and return times using military time format. Include vehicle number and total mileage for each leg of transport.
7. Indicate the number of wheelchairs, attendants, and children per trip using appropriate codes (W, A, C).
8. Ensure all signatures are collected where required: Member's or Attendant's Signature for each leg of transport.

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