METROLift Application

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To apply for METROLift service, submit a Physician or Health Care Professional's Certification Form completed and certified by a physician/certified health professional who is familiar with your disability. Download the form by clicking on the link below. You can attach the completed form below or mail the form METROLift, P.O. Box 61429, Houston, TX 77208-1429.

Physician or Health Care Professional's Certification Form

Mailing Address (if different from the home address):

Emergency Contact Information:

I state that the information I have provided is true and accurate.

I authorize the release of diagnostic and functional information as requested in Step 1 to METRO for the sole purpose of making a determination regarding my eligibility for paratransit service (METROLift) and understand that personal and medical information will be kept confidential.

I understand that intentionally providing false or misleading information or refusal to undergo an in-person interview assessment is grounds for denial of METROLift services. If approved, I agree to follow the rules and guidelines established by METROLift and to promptly inform METROLift of any changes in my residence, phone number and, if applicable, my representative's name and phone number; and any significant change in my condition that would affect my level of mobility. I understand that failure to follow proper procedures or cooperate with METROLift staff, demonstrating illegal or disruptive behavior or, if my condition at any time poses a direct threat to the health or safety of others, such situations may result in either suspension and/or termination of service.