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2. Beyond the Borders Eligibility Form
   Beyond the Borders transportation service helps eligible riders in east and south Pierce County, who are outside of the Pierce Transit service area, access public transit, medical services, employment and shopping. The service is free for eligible riders.
4. We are experiencing a high volume of ride requests at this time. Due to high demand, wait times for available trips may be longer than usual. We appreciate your patience.
6. First Name
7. Last Name
9. Address
11. City
12. State
13. Zip Code
15. Phone Number(s)
16. Email Address
17. What is the best way to reach you?

    1. Phone
    2. Email
    3. Other
19. Please write the name and contact information for the person we should speak to about your eligibility.
21. Check any of the following that apply:

    1. I am 65 years or older
    2. I am 12-17 years old
    3. I have a disability
    4. I am considered low-income
22. Do you use any of the following? Check all that apply:

    1. Wheelchair
    2. Walker
    3. Cane

    1. Crutches
    2. Mobility Scooter
    3. ADA Service Animal
24. Are you registered with the Pierce Transit SHUTTLE?

    1. Yes
    2. No
    3. I don't know
25. Do you need transportation to dialysis?

    1. Yes
    2. No
    3. I don't know

    *Note: As of August 1, 2019, there is a waiting list for new dialysis service.
27. Are you able to ride a regular Pierce Transit Bus if you could get to a stop?

    1. Yes
    2. No
    3. I don't know
28. Where do you need to go? Check all that apply:

    1. Medical appointment
    2. Food bank
    3. Pharmacy
    4. Work
    5. Other
30. Please provide the address of where you need to go.
    Be as specific as possible.
32. Is there anything else you want us to know?

34. Once this form is submitted, someone will be contacting you as soon as possible regarding eligibility. If you don't hear from someone within 7 days, please contact Envoy at 888-375-5558 or email at [email protected]

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field