Marin Access Intake Form |
1. Instructions
Thank you for your interest in Marin Access! Read on to learn more about how to complete the first step of the enrollment process. Information provided during the enrollment process will be used to assess your eligibility for Marin Access programs and services. All information will remain confidential and is used only for the purpose of completing the enrollment process for Marin Access.
Enrollment Process
Enrollment Process
- 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 this form by phone or online.
- 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.
- Upon receipt of a completed intake form, the Travel Navigator team will reach out to you to schedule a phone or virtual interview.
- The interview must be completed by the applicant or a delegate of their choice. The applicant is strongly encouraged to participate in the interview.
- The interview is designed to learn more about your needs and identify which programs and services may be best for you.
- During the interview, you will have the opportunity to ask questions about Marin Access programs and services.
- Following the interview you will be required to submit documentation supporting your application. You may submit required documentation in advance of the interview. Information about required documentation can be found at marintransit.org/marinaccessenrollment.
- Once all required documentation is received, the enrollment review can take up to 21 days.
For assistance or to complete this form by phone, contact us at (415) 454-0902. Translation assistance is available.
Visit marintransit.org/marinaccessenrollment to learn more about the enrollment process.
Si necesita información en otro idioma, comuníquese con Marin Access al (415) 454-0902.
Nếu cần thông tin bằng ngôn ngữ khác, hãy liên lạc với Marin Access theo số (415) 454-0902.
如需其他語言的信息，請致電Marin Access (415) 454-0902。