GOLD2 Transit

📞 Call ✉️ Email

What We Offer

For clients already enrolled with GOLD2 Transit. New here? Complete Sign Up first.

Full Name *

Required

Phone Number *

Required

Signup ID (if known)

Pickup Address *

Required

Destination *

Required

Date *

Required

Time *

Required

Ride Type

Payment Method *

Please select a payment method.

Special Notes

✓

Ride Request Sent!

Thanks, . We'll confirm your pickup time shortly.

BKG-0000

📊 Add to Booking Log (Excel)

Paste into 📋 Booking Log sheet, next empty row, Column C.

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New Client Enrollment

Join GOLD2 Transit

Personal Information

Full Legal Name *

Required

Date of Birth *

Required

Primary Phone *

Required

Email Address

Street Address *

Required

City *

Required

ZIP *

Required

Emergency Contact

Contact Name *

Required

Relationship *

Required

Phone *

Required

Mobility & Medical Needs

Mobility Aids Used

Assistance Level

Independent Minimal Moderate Full Assist

Medical Conditions / Notes

Transportation Preferences

Services Needed

Frequent Destinations

How did you hear about us?

Preferred Payment Method

Select how you prefer to pay. This is saved to your record so it's on file for every future ride.

Please select a payment method to continue.

Insurance Provider / Policy # (if applicable)

Caregiver / Family Member

Optional — complete if a caregiver coordinates rides on your behalf.

Caregiver Name

Relationship

Caregiver Phone

Service Agreement

Scheduling: Rides must be scheduled 24–48 hrs in advance. Call/text 947-465-1984.

Cancellation: 24-hour notice required. Late cancellations/no-shows may incur a fee.

Payment: Due at time of service. No personal checks.

Safety: Seatbelts required. Drivers assist boarding but do not lift clients.

Privacy: Information kept strictly confidential, used only for transportation services.

Printed Name *

Required

Signature — type full name *

Required

By signing, I agree to all GOLD2 Transit policies and authorize use of my information for transportation services.

✓

Welcome to GOLD2 Transit!

Thank you, . Your enrollment is complete.

SGN-0000

Save this ID — reference it anytime you book.

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Paste into 🌐 Client Signups sheet, next empty row, Column C.

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Your Rides

My Trips

Get In Touch

We're Here to Help

📞

Call or Text

(947) 465-1984

For scheduling, questions, and same-day availability.

✉️

Email Us

gold2transit@gmail.com

We respond to all emails within 1 business day.

🕗

Hours of Operation

Mon – Fri | 8:00 AM – 6:00 PM

After-hours rides available with a $20 fee.

💳

Payment Methods

Cash · CashApp $gold2transit · Zelle · Venmo Balleyb25 · Credit/Debit · Insurance · Medicaid/Medicare