Skip to content
(713) 555-0148
info@cadencemobility.com
Mon-Fri: 6:00am – 6:00pm
Sat - Sun: By Appointment
Home
About Us
Services
Book a Ride
Contact Us
Book a Ride
Home
About Us
Services
Book a Ride
Contact Us
Home
About Us
Services
Book a Ride
Contact Us
BOOK A RIDE
Schedule Your Ride
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Next: Trip Type
Transportation Type
*
Ambulatory
Wheelchair
Hospital / Facility Discharge
Ambulatory: best suited for passengers who can enter and exit the vehicle independently or with minimal assistance. Wheelchair: includes wheelchair securement, boarding assistance, and door-to-door service.
Back
Next: Trip Details
Trip Type
*
One-Way
Round Trip
Recurring
Back
Next: Passenger Information
Pickup Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Destination
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Pickup Date & Time
*
Date
Time
Appointment Time
*
Date
Time
Return Time
Date
Time
Required for round-trip bookings. If the return time is not known, select Will Call below.
Return Trip Status
Scheduled return time
Will Call
Extra Stop Address
Optional. Extra stop: $25 plus $1.50/mile.
Trip Mileage (one-way)
Mileage is intended to be populated by the Google Maps/Routes integration. Do not enter a guessed mileage when live routing is connected.
Extra Stop Mileage
Used with the extra-stop charge of $25 plus $1.50/mile.
Additional Services / Charges
Additional passenger (+$20)
Excessive cleaning ($75–$200, if applicable)
Excessive cleaning is assessed when applicable. Additional passenger is $20.
Back
Next: Recurring Details
Passenger Name
*
First
Last
Phone
*
Email
*
Mobility Requirements
Please tell us about mobility needs, assistance requirements, wheelchair information, or other details relevant to the ride.
Companion / Caregiver
*
No companion / caregiver
Yes, companion / caregiver traveling
Companion / Caregiver Name
Additional Passenger Count
Additional passenger charge: $20 each.
Back
Next: Review & Price
Recurring Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Recurring Start Date
Date
Time
Recurring End Date / Duration
Date
Time
Provide an end date when known. The recurring payment workflow is intentionally flexible because the client has not finalized it.
Recurring Pickup Window
Date
Time
Recurring Appointment Time
Date
Time
Driver Preference
No preference
Preference requested (where possible)
Family Notifications
Yes
No
Back
Next: Payment
Estimated Days Appointment
Back
Pay & Confirm Ride
Cancellation Policy Agreement
*
I have read and agree to the Cadence Mobility cancellation policy and understand that payment must be prepaid or secured by a valid payment method at booking.
Credit / Debit Card
*
Credit Card field is disabled, Square account connection is missing.
Back
Pay & Confirm Ride
