Register for our community transport services


CONTACT DETAILS

Please use the following format: dd/mm/yyyy

Please give details of someone we can contact on your behalf in an emergency.


TELL US ABOUT YOURSELF

Please check all the statements that apply to you

Do you use a walking aid?

If you use a scooter please provide details of the make and model. We need to ensure that your scooter can be transported safely and unfortunately we are not able to accommodate Class 3 scooters which are not designed for use on the road.

Please note that for safety reasons it is not possible for you to remain on your scooter on the passenger lift or inside the vehicle. For this reason you will be need to be able to use the passenger lift or the side entrance independently.

If you use an electric wheelchair please provide details of the make and model. We need to ensure that your wheelchair can be transported safely.

Please note that it will be necessary to disengage the drive clutches on the wheels of your electric wheelchair when boarding and alighting.


MONITORING INFORMATION

How did you hear about Sheffield Community Transport?

What is your ethnicity?


DECLARATION

Please tick the statements below to confirm that: