Yes, depending on your personal situation, different forms may need to be completed before booking transportation with Veyo. Here are some of the most common examples:
- If you are unable to travel by public transportation, a Medically Appropriate Mode Form must be completed by your healthcare provider indicating the most medically appropriate mode(s) of transportation for you.
- If you live in an urban area and need to travel 10 or more miles to an appointment, or, if you live in a rural area and need to travel 20 miles or more to an appointment, a Closest Provider Certification must be completed by your healthcare provider to verify that—for medical reasons—you need to travel beyond HUSKY Health’s approved distance from your home address.
- A parent, legal guardian, or caregiver is required to travel with any child under 16 years of age. Parents must fill out, sign, and return the Minor Consent to Travel Form to Veyo before any child between 12-15 years old will be able to ride alone. Any child who behaves inappropriately while riding alone will need to be accompanied by an adult for all future rides.
- If you need a medically required attendant, escort, aide, assistant, or companion to ride with you, your healthcare provider will need to fill out and submit the Companion Request Form before your trip. Once your healthcare provider has verified that the person (for example: your sibling or your parent for family counseling) is needed at your appointment, the person may ride with you.
- Your newborn or nursing infant (up to 6 months old) may ride with you, as long as you provide an appropriate car seat for the child.
- If a person does not meet the criteria above, they will not be able to ride with you to or from your appointment.
Each form can be downloaded at ct.ridewithveyo.com/forms or requested over the phone by calling the Veyo Contact Center at 855-478-7350.
You can find out your form(s) approval status by calling 855-478-7350. All forms must be signed by a licensed treatment professional (example: MD, LCSW, LMFT, APRN, RN). Signatures from Certified Nursing Assistants, Patient Techs, Receptionists, Medical Assistants, etc. are not acceptable. Please make sure you call the Veyo Contact Center if any information (such as your address, phone number, etc.) changes.