Forms
Applications, reports, and program documents in one place.
General
- Clearinghouse for Older Road User Safety Link Open link
- Employment Application Online form Open online form
- VTC Agency Brochure PDF Download PDF
Client Forms
- Carthage Area Hospital Referral Form Online form Open online form
- Client Application for Service (printable) PDF Download PDF
- New Client Application Online form Open online form
- VTC Client Recertification Form Online form Open online form
New Volunteer Forms
- New Volunteer Application (downloadable) PDF Download PDF
- New Volunteer Application (online) Online form Open online form
Medicaid Family Drivers
Jefferson County only- How do I get paid to drive family members who have Medicaid? PDF Download PDF
- Medicaid Family Driver Application Packet PDF Download PDF
Medicaid Self Drive
Jefferson County only- How do I get reimbursed if I drive myself? PDF Download PDF
- Medicaid Self Drive Application Packet PDF Download PDF
First Mile Last Mile Program
St. Lawrence County only- FMLM No Show Policy PDF Download PDF
- What is the First Mile Last Mile program? PDF Download PDF
Volunteer Driver Forms
- 2023 Voucher Due Dates PDF Download PDF
- Accident/Incident Report (online) Online form Open online form
- Accident/Incident Report Form PDF Download PDF
- Background Check Form (printable) PDF Download PDF
- Background Check Form (submit online) Online form Open online form
- Jefferson County DSS Release Form PDF Download PDF
- New Driver Direct Deposit Authorization Form PDF Download PDF
- NYS Justice Form PDF Download PDF
- St. Lawrence County DSS Release Form PDF Download PDF
- State Central Register Database Check (SCR3370) PDF Download PDF
- Trip Voucher PDF Download PDF
- Update Volunteer Documents (pdf, jpeg or gif) Online form Open online form