Welcome to CARTS Schedule a Ride registration page.   The purpose of the "Schedule a Ride” registration system is to allow established CARTS clients to schedule rides online.  Please complete the form below to create a user name & password.  Once you have a user name and password you will be able to schedule your rides online.  If you have any questions or need assistance please call 262-8900. ** All fields must be completed or you will be returned to this page. ** *First Name: *Last Name: Phone: -- *Email Address: *Username: *Please enter a password: *Please verify password: *Gender: Male Female *Date of Birth: January February March April May June July August September October November December 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 *Ethnicity: *Marital Status: Single Married *Number in Household: 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 *Physical Address: *City: *State : *Zip Code: Directions to your home: Do you have any mobility impairments that we need to consider? None Cane Stretcher Visual Impairment Walker Wheelchair Are there any special circumstances that we need to know in order to give you the best ride? *Do you receive Medicaid? Yes No *Do you have children participating in the Denali Kid Care Program? Yes No Choice Waiver for services? Enter your 8 digit beneficiary number: Who would we contact in case of emergency? Please list 2 contacts and their relationship to you. * Emergency Contact #1 - Full Name: *Relationship: *Phone: -- * Emergency Contact #2 - Full Name: *Relationship: *Phone: -- * Do you have a case manager, independent living counselor or caseworker? Yes No Case Manager's Full Name: Case Manager's Phone: -- * denotes required field