Handi-Van Application Form

Applications are reviewed by the Handi-Van Elegibility Committee who meets monthly, every 4th Tuesday. All applicants will be advised by letter.

Please note that completed Handi-van Applications will only be accepted by fax to 905-335-7878, (if by fax please mail original) or by mail to:

          Burlington Handi-van
          3332 Harvester Rd.
          Burlington, ON, L7N 3M8

For details on the Handi-van application process, please view the Handi-van Application Form Instructions sheet. PLEASE NOTE: There are two parts to the application process that must be completed. Both forms must be sent in order to fulfill the application process.

Handi-van Application Form - Part A (For applicants)

Handi-van Application Form - Part B (For medical professionals to complete and MUST accompany Part A)

If you have any questions on the application process, please call Handi-van at 905-639-5158.