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SS Medical Transportation
NC, SC & Washington, DC NEMT • Luxury Fleet • Care First
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Ride Booking Form
Full Name *
Phone *
Email *
Service Needed *
Select
Non-Emergency Medical Transportation (NEMT)
Ambulatory Transport
Wheelchair Transport
Long-Distance Transport
Pickup Location *
Drop-off Location *
Date Needed *
Pickup Time *
Trip Type *
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One-way
Round-trip
Special Transportation *
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Ambulatory
Wheelchair
Stretcher (if available)
No special transport required
Additional Notes
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