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Click ‘Get Form’ to open the palm tran connection application in the editor.
Begin with Part 1: General Rider Information. Fill in your last name, first name, middle initial, and address details. Ensure all fields are completed accurately.
In Part 1, indicate any mobility aids you use by checking the appropriate boxes. This information is crucial for determining your eligibility.
Proceed to Part 2: Applicant Signature Page. Sign and date the form to certify that all information provided is true.
If applying for specific programs, complete Parts 3, 4, and 5 as applicable. Attach necessary documentation for income verification or proof of age/disability.
Review all sections for completeness before submitting your application through our platform.
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the Call Center at 833-HHA-WILL. PBC Palm Tran: 561-841-4200. Palm Tran CONNECTION: 561-649-9838. Area Agency on Agings Elder Helpline: 1-866-684-5885Read more
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