SCHEDULE A RIDE

Schedule A Ride

Schedule a Ride: (719)-401-7870 or click on Schedule a Ride 24/7

Unprecedented customer services are our goal. We are a non-emergent medical transportation (NEMT) service that serves the El Paso County Community by providing on-time, caring, and affordable transportation to and from healthcare facilities.

Schedule a Ride Online: Trip Information

First Name

Last Name

Medicaid Number

Phone Number

Field label

---------- Home/Pick-Up Address ----------

Street Address

City

Zip Code

Free Text

---------- Destination Address ----------

Street Address

City

Zip Code

Appointment Date

Appointment Time

Notes/Comments

Free Text

---------- Agreement and Signature ----------

Free Text

I certify that the information provided is accurate to the best of my knowledge. If Axel Medical Transportation does not receive required documentation, if applicable, within one business day of the initial request date, the request will be denied. DENIED REQUESTS CAN ALWAYS BE RESUBMITTED WITH THE REQUIRED DOCUMENTATION.

Type your name to denote signature

Date Signed

HOURS

Monday - Friday

7:30am - 5pm

CONTACT US

(719) 401-7870

axtransit@gmail.com

Fax (719) 259-3148

LOCATION

5180 N. Union Blvd Ste. 203

Colorado Springs, CO 80918