Schedule Your Ride

Please book at least 24 hours in advance when possible. For same day rides, please call dispatch at [PHONE NUMBER]

Rider Information

Rider’s Full Name *

Rider’s Date of Birth *

Rider’s Phone

Rider’s Weight *

Booking Contact (if different)

First Name

Email *

Phone *

Your Relationship to Rider

Trip Details

Service Type *

Ambulatory

Wheelchair

Stretcher

Not Sure

Pickup Address *

Pickup Date & Time *

Destination Address *

Date Picker 3rw5

Appointment Time at Destination

Return Trip Needed?

Yes

No

Not Sure

If Yes – Return Pickup Time

Special Requirements

Multi Line 99u7

Companion Riding Along?

Yes

No

Any other notes for the driver?

Payment

How will this ride be paid?

Private Pay

Healthcare Provider/Facility Bill

Insurance

Not Sure – please call me

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Guardian Angel Transit Care

Michigan-based non-emergency medical transportation for wheelchair, stretcher, and ambulatory rides.

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⚠ Guardian Angel Transit Care provides non-emergency medical transportation only. In a medical emergency, call 911.