Provider Notes - Florida Disabled Parking Permit Eligibility Check
This 2-minute screening confirms whether your situation falls within our scope before any payment or booking. No card required.
Are you physically located in Florida right now?
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Yes
No
Are you applying for a Florida disabled parking permit?
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Yes
No
Do you consent to a telehealth evaluation by video?
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Yes
No
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About Your Condition
Do you have a musculoskeletal or neurological condition that limits your ability to walk?
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Yes
No
Is your walking limitation ONLY due to heart, lung, oxygen use, or vision problems (with no orthopedic or neurological cause)?
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Yes
No
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About your walking limitation
Can you walk 200 feet (about one block) without stopping to rest?
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Yes
No
Approximately how far can you walk without stopping?
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Less than 50 feet
50-100 feet
100-200 feet
More than 200 feet
What forces you to stop walking? (Select all that apply)
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Pain
Weakness
Instability
Numbness
Risk of Falling
Do you require any of the following due to your orthopedic or neurologic condition? (Select all that apply)
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Cane
Walker
Brace
Wheelchair
Assistance From Another Person
None
Is this limitation present most days?
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Yes
No
Expected duration of this condition:
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Less than 6 months
6+ months
Permanent
Is this request due to medical necessity related to your walking limitation, not convenience?
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Yes
No
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Almost Done
Please confirm a few details so we can route you to booking.
Full Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
ZIP Code
I attest that the information above is true and accurate. I understand that providing false information to obtain a medical certification may constitute fraud under Florida law.
I attest and agree
Submit & Continue to Booking
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