Apply for Service

Who is Eligible?

Do you, or someone you know, have difficulty meeting your health care needs due to a lack of transportation?

Green Cars for Kids is a 501(c)(3) nonprofit organization that provides transportation to medical, dental, and mental health care services for children and expectant mothers who are transportation disadvantaged. Funding for our service is provided by caring and concerned individuals, foundations, corporations, local governments, and other organizations with an interest in improving the health and wellness of children. We currently serve pregnant women and children in Broward County, Florida only.

Important Note: We currently only serve patients in Broward County. For service, please call 561-400-9835 if you live in the following zip code areas: 33311, 33313, 33309, or 33319.

Fill out the form below To Begin Requesting A Ride:

Request A Ride

Patient Name(Required)

First Middle Initial Last

Is The Patient A Minor?(Required)

Guardian/Parent Name of the Patient(Required)

Patient Best Contact Phone Number(Required)

Patient Email(Required)

Patient's Racial and/or Ethnic Identity(Required)

Patient Mailing Address

Street Address Address Line 2 City State ZIP Code

Patient Birth Date(Required)

Last 4 Digits Of Patient's Social Security Number(Required)

Patient Pick Up Address(Required)

Street Address Address Line 2 City State ZIP Code

Patient Drop Off Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Reason for Transportation Request(Required)

How Long Will Your Appointment Be?(Required)

Apply for Service

Who is Eligible?

Fill out the form below To Begin Requesting A Ride:

Request A Ride

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