Schedule a Service

Airridecolorado01@gmail.com

Colorado, United States

720-668-2599

Service Hours

24/7

AirRide Colorado provides secure behavioral health transportation for clients who need special attention, supervision, or support during transport.

We specialize in mental health crisis transportation, emergency crisis transportation, hospital-to-hospital transfers, detox/treatment admissions, and other sensitive transport needs.

Please note: This is not Non-Emergency Medical Transportation (NEMT). If you are looking for NEMT services, please contact an approved NEMT provider.

Air Ride Colorado is not an ambulance service and does not provide emergency medical care. If someone is experiencing a medical emergency or immediate life-threatening danger, call 911.

Passenger Information

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Passenger full Name *

DATE OF BIRTH *

Requested Date of Transport *

PICK UP TIME *

ROUND TRIP YES OR NO ? IF YES RETURN PICK UP TIME ? *

reccurring restraint Transportation

Contact Information Requesting Transportation *

Client Contact Information

Pick-Up Facility Name And Address *

Drop Of Facility Name And Address *

Medicaid Number

Will this be a reccurring visit? *

Does the Patient Require Special Equipment

optional

CRISIS TYPE *

SUBSTANCE USE DISORDER CRISIS
MENTAL HEALTH CRISIS
BEHAVIORAL HEALTH CRISIS

Type of Transportation Requested *

Voluntary Behavioral Health Crisis Transport
Involuntary transportaion
Transfer to High level of Care
voluntary Hold Transport (M-1/72-Hour Hold)
Facility-to-Facility Transfer
Hospital or Emergency Department Discharge
Detox or Substance Use Treatment Admission
Court-Ordered Transport
Law-Enforcement-Referred Transport
Jail or Detention Facility to Treatment
Other

s the client currently restrained or is restraint being requested? *

IF YES Restraint use is not guaranteed by submitting this form. Air Ride Colorado follows applicable law, licensing requirements, staff training, company policy and an individualized safety assessment

Schedule a Service

Service Hours

Passenger Information

Expert Mental And Behavioral Health Crisis Transport