This program is offered in collaboration with the Glendale Dialysis Subsidy program and is available only in that service areas. Patients who qualify for the taxi subsidy and are unable to pay the patient portion of the fare can apply with NKF AZ for assistance in paying the patient portion of the fare. Qualifying patients are approved for up to six months at a time (a maximum of 26 rides per month).
Patients whose insurance provides non-emergency transportation are not eligible.
Eligibility (In addition to the General Eligibility Requirements above):
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Patients must first qualify for the taxi voucher program; after qualifying for that program, the patient must demonstrate financial need, per the Financial Statement.
Forms:
- To start a new Transportation Assistance application use
https://www.GrantRequest.com/SID_6273?SA=SNA&FID=35007 - To access a saved or previously submitted application use https://www.GrantRequest.com/SID_6273?SA=AM
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Financial Statement (if not already completed within the last six months for other assistance requests, or if there are changes to income)
Renewal:
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To start a new renewal Transportation Assistance application
https://www.GrantRequest.com/SID_6273?SA=SNA&FID=35007 - To access a saved or previously submitted renewal application use https://www.GrantRequest.com/SID_6273?SA=AM
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Renewals should be submitted in January and July for all qualifying patients, using the Financial Statement