Ride Request Form

Ride Request Form
1. You must be an approved rider in the Out and About program before submitting a ride request.
 
2. Ride requests must be received at least 7 days in advance. Please plan accordingly.
 
3. Out and About coordinator will call to confirm ride details and receipt of the request.
 
4. Rides may be scheduled up to one month in advance.
 
5. Repeating rides must be resubmitted each month (e.g. weekly trips to the Spreckels Center).
 
6. Please be cognizant of peak travel times – early morning and late afternoon rides are more difficult to accommodate.
 
7. Rides are provided from 8 a.m. – 5 p.m. Monday through Saturday except during City of Coronado observed holidays.
 
8. All drivers are volunteers. Rides are not guaranteed.
 
9. Please contact Coronado Seniors Out and About staff with any questions at (619) 522-6302 or by email at outandabout@coronado.ca.us

 

First Name
Last Name
Phone
Email
Preferred Method of Contact Email    Phone  
Pickup Address
Pickup City
Pickup Zip
Destination Name
Destination Address
Destination City
Destination Zip
Date of Appointment
Pickup Time
Time of Appointment
Appointment Duration
Appointment Type
Do you require a return ride?Yes  No
Return Ride Time
Return Pickup Address
Return Pickup City
Return Pickup Zip
Do you require any additional stops?Yes  No
Please list your additional stops:
  

 



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