Application for Assistance:
NOTE: We are excited and anxious to begin helping people but before we can we have to receive enough donations. At this point we are unable to accept applications, but we will as soon as funds become available.
Robert's Rides is dedicated to helping as many people get home as we possibly can, but in order to do that we need some information from you. All information given here is confidential and will not be used for anything other than determining medical suitability and need in order to help finance the transport of your loved one.
Disclaimer: Robert's Rides believes that a support network is a very important part of a patientís recovery, and that is why we want to help reunite patients with their loved ones. That being said, we also understand that sometimes it is medically necessary for a patient to remain in a hospital out of town for procedures or treatments that they may not otherwise be able to receive. If this is your case, you or your loved one may still be eligible, but we need an official letter from a doctor who specializes in the necessary treatment or procedure releasing the patient to home hospitals for the recuperation period.
Please fill out or obtain the following documents to the best of your ability, and then submit:
- Information Sheet (Coming Soon!)
- Waiver Form (Coming Soon!)
- Official Doctors Letter (On Hospital Letterhead) stating that the patient is fit to be moved and that the receiving hoptial will not be a detriment to the paitents health.
- Official Letter from a receiving hospital in or near the patientís support network that offers at least the same level of care that the patient is currently receiving.
- Release form authorizing Robertís Rides to use the patientís story (not medical records) in order to further our cause.
- If patient is unable to speak for him or herself - 2 forms of evidence that the receiving hospital is where the patient lives or will be near a support network (marriage certificate, bills in the patientís name, current state-issued ID, birth certificate(s) (childrenís or the patientís), medical power of attorney, living will, etc.)
- Estimate from Angel MedFlight (or other similar transport service) as to how much the retainer for a transport will cost in the form of an official letter which also states that they find the patient to be transportable if the retainer is met.
- Notification from either the insurance company itself, Angel Medflight (or other transport service) or the hospital that the insurance company is denying the transport.