Book Your Ride

Request a Ride Online

Fill out the form below and we'll confirm your booking within 1 hour. Prefer to call? (954) 204-1873 — we're available 24/7.

Transport Type

Select the type of transport you need

Patient Information

Details about the person being transported

First Name*

Last Name*

Date of Birth*

Phone Number*

Email Address

Pickup & Destination

Where are we picking you up and where are you going?

APickup Location

Street Address*

City*

ZIP Code*

BDestination

Facility / Doctor Name*

Street Address*

City*

ZIP Code*

Appointment & Timing

When is your appointment and when do you need pickup?

Appointment Date*

Appointment Time*

Requested Pickup Time*

I need a return trip

Insurance & Special Needs

Optional — helps us prepare the right vehicle and billing

Insurance Provider

Member ID / Policy #

Special Needs or Notes

Emergency Contact

Someone we can reach if needed

Contact Name*

Contact Phone*

I confirm that the information provided is accurate and I agree to Vital Care Transport's Terms of Service and Privacy Policy. I understand that this is a request and not a confirmed booking until I receive confirmation.

We'll confirm your booking within 1 hour during business hours

Prefer to Call?

Our team is available 24/7 to take your booking over the phone.

(954) 204-1873

What to Expect

Confirmation within 1 hour
Driver's name & contact sent to you
Reminder call the day before
Driver arrives 10–15 min early
Door-to-door escort included

Insurance Accepted

We accept Medicaid, Medicare, and most major insurance plans. Not sure if you're covered? Call us and we'll check for you — no obligation.