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Request a Ride

Tell us about your trip.

This form is for non-emergency medical transportation requests only. For medical emergencies, call 911.

Leave this field blank

Passenger

Passenger name *

Requestor name (if different)

US phone number *

Email *

Trip

Pickup address

Street address *

City *

State *

ZIP code *

Destination address

Street address *

City *

State *

ZIP code *

Appointment date/time *

Requested pickup time *

Round trip

Assistance & preferences

Ambulatory / mobility assistance information

This is a recurring trip

Number of companions

Special transportation instructions

Preferred contact method

Submitting a request does not confirm your ride. HopePath will follow up to confirm details.

© 2026 HopePath Medical Transportation LLC. Non-emergency medical transportation only — for emergencies, call 911.

Zero-Tolerance Policy Privacy Policy Contact

To report a suspected zero-tolerance violation, contact HopePath directly, or report complaints to the City of Dallas by calling 3-1-1.