Marin Access Intake Form |
1. Instructions
Thank you for your interest in Marin Access! Read on to learn how to complete the first step of the enrollment process. The information you provide will be used to assess your eligibility for Marin Access programs and services. All information will remain confidential and will only be used for the purpose of completing the enrollment process for Marin Access.
- Submit Intake Form
- Complete Interview
- Submit Documents
- Enrollment Review
Enrollment Information
- If you wish to enroll for Marin Access, you must complete this form. You also have the option of completing the intake form by phone.
- Responses to all questions (unless noted as optional) are required. Completion of this form does not amount to an eligibility determination. Incomplete forms will not be processed.
- Once we receive your intake form, the Travel Navigator team will contact you to schedule a phone interview.
- The applicant must participate in the interview, but may be assisted by a delegate of their choice.
- The interview is designed to inform us about your needs and identify which programs and services may be beneficial to you.
- Following the interview you will be required to submit documentation supporting your application. Information about required documentation can be found at marintransit.gov/marinaccessenrollment.
- Once all required documentation is received, the enrollment review can take up to 21 days. Applications are reviewed in the order received and cannot be expedited.
For assistance or to complete this form by phone, contact us at (415) 454-0902. Translation assistance is available.
Visit marintransit.gov/marinaccessenrollment to learn more about the enrollment process.
Si necesita información en otro idioma, llame a Marin Access al (415) 454-0902.