RTP provides complementary para transit transportation to eligible people living in, or visiting, the Greater Portland area.

Through our Complementary Para Transit services, RTP provides an equivalent accessible transportation option to people who are unable to use the fixed-route bus services of METRO or South Portland Bus Service because of disability. RTP provides rides, from origin to destination, within ¾ of a mile of the fixed bus routes running in Portland, South Portland, Falmouth, Gorham, and Westbrook.

Transportation services are accessed by completing this application and being certified through RTP, or if you are visiting from another area, by providing RTP with documentation of ADA certification from a transportation service in another area of the country.

Who should you apply for ADA services?

• People who, because of a disability, are unable to use the fixed-route public bus services.

How do people apply for ADA services?

• Complete this application and sign the Release of Information section.
• Applicant completes parts 1 through 7
• Have your doctor, rehabilitation specialist, or other qualified health care provider complete and sign the professional verification section.
• Licensed medical professional completes and signs Part 8
• See back of this page for where to send completed application.

**The information obtained in the certification process will be used only in the facilitation of travel. The information you provide will not be provided to any other person or agency.**

If you need help completing this application or have questions about this application please call RTP at 774-2666 Ext. 7516.

ADA Appeal Process

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Procedures

• The applicant will be provided reasons in writing (or in a format accessible to the applicant) for denial of eligibility.
• The applicant has 60 days from the date of the denial to request an appeal hearing.
• The applicant has the right to have their case heard in person and bring an advocate or personal representative to the hearing scheduled by RTP, Inc.
• RTP, Inc. will make a decision on the appeal as soon as possible. The decision cannot exceed 30 calendar days or the applicant may receive service beginning the next calendar day until a decision is made.
• RTP, Inc. is responsible for establishing local appeals procedures. RTP, Inc. will:
  1. Establish an appeals panel.
  2. The panel will be structured to ensure an impartial review.
  3. The panel will consist of:
     • Three persons:
       • One “peer”.
       • One person with applicable professional experience working with persons with disabilities.
       • One member of the RTP Board of Directors.
  4. The decision of the appeal panel will be provided in writing, and will be final.
  5. Applicants may reinitiate the service eligibility process any time there is a change in their functional ability which prevents them from using the fixed route systems.
  6. RTP will provide auxiliary assistance (e.g. interpreter services, transportation, material in an accessible format, and so forth) to ensure the applicant may fully participate in the hearing.

Regional Transportation Program, Inc. 

ADA Application for Transportation Services

Americans with Disabilities Act Para Transit (ADAPT)

Part 1: Personal Information

Part 2: Information Regarding Disability

Part 3: Travel Assistance:

Part 4: Functional Ability

Part 5: Verification

I understand that the purpose of this application is to determine my eligibility to use ADAPT transportation through RTP. I understand that the information about my disability contained in this application will be kept confidential and shared only with professionals involved in evaluating my eligibility. I certify to the best of my knowledge the information provided in this application form is true and correct. | understand that providing false or misleading information could result in my eligibility status being re-evaluated. I also understand that should any of my information change during or application process, I am required to notify RTP to determine if my eligibility needs to be re-evaluated at that time.

Part 6: Application Assistance

Please provide the following information:

Part 7: Authorization to Release Information

(to be signed by applicant or legal guardian)

I give permission for the medical provider filling out the "Medical Verification Form" to verbally discuss protected health information related to:

My disability which prevents me from using METRO/South Portland Bus Service (including symptoms, diagnosis, medications & treatment plans)

The disability stated in the attached ADA application (including symptoms, diagnosis, medications & treatment plans)

Any additional medical information which may help in determining my eligibility for para-transit

The information may be discussed with the entity listed below

Name: Regional Transportation Program, Inc

ADA Application Processor

1 Ledgeview DR

Westbrook, ME 04092

(207)774-2666

(207)828-8899 (fax)

I understand that I have the right to revoke my permission at any time in writing except where my medical provider has already made disclosures in reliance upon this request.

MAKE SURE THAT THE MEDICAL PROVIDER WHO IS FILLING OUT THE "MEDICAL VERIFICATION FORM" IS THE PROVIDER WHO CAN SPEAK TO YOUR DISABILITY AND THE MEDICAL REASONS WHY YOU NEED ADA PARA-TRANSIT SERVICES

Part 8: Medical Verification (to be completed by Licensed Medical or Mental Health Professional

• In accordance with the American's with Disabilities Act of 1990, paratransit service is available only for persons who because of a disability are prevented from taking the regular fixed route bus The fact that the applicant's medical condition makes using the public transportation more difficult is not a basis for eligibility for service.
• Please focus your responses on the functional ability of the applicant. If a person is eligible for some trips but not others, please specify any limitations.
• Please review the information contained on the application as provided by the Applicant or Applicant's representative.
• If an individual has a temporary medical condition please provide information as to the duration of that medical condition.
• Age, low-income or the inability to drive are not a factor in determining an applicant's Paratransit eligibility. Please print client's name and answer all questions completely in your professional opinion

Licensed Medical or Mental Health Professional Verification Form

I hearby certify that the information provided on the "Licensed Medical or Mental Health Professional Verification Form" portion of this application is true and correct. 

Thank you for your assistance in completing this form. RTP in accordance with the American's with Disabilities Act of 1990, will use the information provided to determine the applicant's eligibility for Paratransit Services.