WSIB Book A Ride

Make Sure to Fill Out All Required Fields…
After You Click The Send Button Watch
For The Message Saying
Thank you for your message. It has been sent.”

    Client Name*
    Client Mobile Number*
    Escort Authorized For Solo Travel*
    ID Number*
    Approved Pickup Address*
    Approved Drop Off Address*
    If Additional Approved Addresses:
    Activation Date*
    Activation Time*
    End Date*
    End Date Time*
    Special Request*
    Service Code*
    Senders Name*
    Senders Email*