VENTURA COUNTY AREA AGENCY ON AGING ELDERHELP PROGRAM (EHP) 2026

1. Click ‘Get Form’ to open the VENTURA COUNTY AREA AGENCY ON AGING ELDERHELP PROGRAM (EHP) Transportation Referral Form in the editor.
2. Begin by filling out the Referring Agency Info section. Enter the Requesting Agency, Today’s Date, Requestor's Name, Phone Number, and confirm if the Client has been informed of this referral.
3. In the Bus Tickets section, select the type of tickets needed for transportation. Ensure you have a copy of the ADA Card ready for submission.
4. For EHP Medi-Ride Transportation Requests, indicate the type of vehicle required and provide any comments or concerns for the driver.
5. Detail your appointment information including Doctor/Hospital Name, Type of Medical Practice, Date/Time of appointments, and whether an escort is going along.
6. Complete the Required Info About The Client section with personal details such as Client Name, Phone Number, Address, Date of Birth, and Marital Status.
7. Finally, review all entries for accuracy before submitting via email to Elder.Help@ventura.org or calling 805-477-7300.

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