Scheduler -Access Service

Access Services

Online Eligibility System

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Your Rider ID # is

Confirmation

To:

Keep your Rider ID# in a safe place. You will need to provide your Rider ID# when communicating with Access. If you use the online systems, your Rider ID# is your Username.

Access Customer Support 800.827.0829

TDD 800.827.1359

Request Rider ID #

Welcome! You can request your Rider ID # online by filling in the form below.

* Required Information

I have a different mailing address

TDD

Mobile

TDD

Mobile

I do not have a Medi-Cal ID #

Please provide emergency contact information

Select the preferred format you wish to have information sent by mail.

Submit

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Your Rider ID # is

Success! Your Rider ID has been created. Save this number! We will use it for everything related to Access Services.

Next Step: Complete and submit your Access Services Eligibility Application

Confirmation

Your Rider ID # is

Your Access Services Eligibility Application will be mailed in

To:

Keep your Rider ID# in a safe place. You will need to provide your Rider ID# when communicating with Access. If you use the online systems, your Rider ID# is your Username.

Note: You can schedule an evaluation appointment when Access Services has received your completed eligibility application.

Eligibility Application Options

Eligibility Packets - You have Options

Great News! Access Services Eligibility Applications can now be submitted online. The Online Application takes approximately 10-15 minutes to complete. If you cannot complete the application in one session, you may save the application-in-process and finish later.

Note: You can schedule an evaluation appointment when Access Services has received your completed eligibility application.

Apply Online Finish Later Mail Application

What is Required for my Online Application?

10 - 15 Minutes and Complete Medical and Contact Info

Completed application includes all contact, medical provider, caregiver, mobility and other information required for approval.

Are you ready?

I AM READY - APPLY ONLINE

Need more time? We will mail your application.

I NEED MORE TIME - MAIL IT TO ME

You are being directed to the Online Application Form

Access Services

Online Eligibility System

800-827-0829

Online Eligibility Application

Your Rider ID # is

Keep your Rider ID# in a safe place. You will need to provide your Rider ID# when communicating with Access. If you use the online systems, your Rider ID# is your Username.

Note: You can schedule an evaluation appointment when Access Services has received your completed eligibility application.