Western New York

Request
A Ride.

All rides are completely free, round-trip, and door-through-door. We serve Erie and Niagara Counties. Fill out the form below and our team will confirm your booking.

⚠ Please Read Before Submitting

Grace period: Passengers must be ready at their scheduled pickup and return times. We can hold for up to 10 minutes. After that, the trip will be cancelled.
Stairs: Our drivers are not able to assist passengers down or up stairs. If your home has stairs, a family member or aide must be present to assist with that portion of the trip.
Service area: We currently serve Erie and Niagara Counties only. Destinations must fall within our service radius.
Purpose: Rides are for recreational purposes only. This service is not for medical appointments.

Passenger Information

This builds your passenger profile for future bookings

First Name *

Last Name *

Date of Birth *

Phone Number *

Home Address *

Trip Details

Where are you going and when?

Pickup Address *

Drop-Off Address *

Trip Date *

Pickup Time *

Return Time *

⏱ Reminder: You must be ready at both your pickup and return times. Our drivers can wait no more than 10 minutes before the trip is cancelled.

Wheelchair & Equipment

Helps us ensure the right vehicle and setup for your trip

Wheelchair Type *

Describe Your Wheelchair

Approximate Wheelchair Weight *

Do you use any additional mobility equipment?

Caregiver / Aide Information

Will someone be accompanying the passenger?

Will a caregiver or aide be traveling with the passenger? *

Yes

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Relationship *

Accessibility & Home Info

Helps us prepare the right support for your trip

Does your home have stairs? *

✓ No Stairs

⚠ Yes, Has Stairs

Important: Our drivers are not trained or insured to assist passengers up or down stairs. If your home has stairs, a family member or personal aide must be present to assist you at both pickup and return. Please confirm this will be arranged before submitting.

Additional Notes

Acknowledgment

Please confirm you've read and agree to our policies

✓

I confirm that I have read and understand The Independence Project's policies. I understand that I must be ready at my scheduled pickup and return times, and that the trip will be cancelled after a 10-minute grace period. If my home has stairs, I confirm that a family member or aide will be present to assist. I understand this service is for recreational purposes only.

Our team will follow up by phone to confirm your booking. Submissions do not guarantee availability.

🎉

Request Received!

Thank you! Our team will reach out by phone to confirm your booking. We can't wait to take you somewhere great.

RequestA Ride.

⚠ Please Read Before Submitting

Request Received!

Request
A Ride.