MI LIFE TRANSPORT
Home
About
Contact
*
Indicates required field
Participate's Name
*
First
Last
[object Object]
Participate's Pick up Address
*
Line 1
Line 2
City
State
Zip Code
Country
Doctor or Facility Name
*
First
Last
Drop off Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Submit
Service Needs
*
Ambulatory
Wheelchair
Other (additional information)
Additional Information
*
Email
*
Submit
Ambulatory Services
Wheelchair Van Services
Wait time Fees
20
25
36
Pick up
Pick up
Per Hour
$2.55 per mile
$2.85 per mile
$18 per half hour
$.75 Unloaded per mile
$.85 Unloaded per mile
N/A
CONTACT US
Phone
:
1-888-645-4330 toll free
231-577-2082 local
Email:
[email protected]
Home
About
Contact