A printer iconPlease complete the application and then print it out. Note you will not be able to save or submit the application below electronically. All fields are required unless marked with "(Optional)". Part C of the application will be included in your printed form; ask your healthcare professional to fill this out for you.  

Part A: Eligibility Declaration

To be filled out by the applicant or the applicant's legal guardian. Please sign and date after prinitng.

By completing, signing, and submitting this application to the TTC, I am stating that the information provided is true and accurate. I understand that submitting false information constitutes fare evasion and that fraudulent use of a TTC photo ID card is an offence under TTC By-law No. 1 subject to a fine and permanent loss of the ID card.

I authorize the TTC to contact my health care professional and to receive additional information, including personal health information, if additional information, documentation or clarification is required to process my application.

Signature of Applicant or Legal Guardian
Date
 

Part B: Applicant Information

To be filled out by the applicant or the applicant's legal guardian.

 
 
 
 
 
 

 
 
 

 

 

 

 


Are you a registered Wheel-Trans Customer?
 
 


If yes, can you be left unattended at your destination?
 

Would you be willing to participate in a survey about the program?
 

This application was completed by:
 
 

Part C: Medical Information

Must be completed by an authorized regulated Health Care Professional.

(Family Doctor or other Physician, including Psychiatrist, Physiotherapist, Optometrist, Audiologist,Psychologist, Chiropractor, Occupational Therapist, Speech Language Pathologist, or Registered Nurse)

 

 

Required 
 

 
 
 

Is the applicant's disability:
 


 
 

I certify that the applicant is a person with a disability who, because of the disability, needs to be accompanied by a support person to assist with communication, mobility, personal/medical needs or with access to goods, services or facilities. I certify further that the information I have provided in this application is accurate and complete to the best of my knowledge.

 
Stamp of Medical Professional
Signature of Medical Professional
Date
 

The personal information on this form is collected under the authority of the City of Toronto Act, 2006, S.O. 2006, c.11, Schedule A, and the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M.56, S.31. This information is collected and used for the purpose of the TTC Support Person Assistance Program, including ligibility determination and notifying applicants of any future changes to the Program. Questions about this collection can be directed to the TTC Customer Service Department, 1900 Yonge Street, Toronto, Ontario, M4S 1Z2, or by calling 416-393-3030.

 
 
For TTC Photo ID Office Use Only
 
 

Mailing Information

If mailing the application to the TTC, ensure that the following are enclosed:

  • Completed application form (Parts A and B by the applicant or legal guardian, and Part C by an authorized regulated health care professional)
  • Two (2) colour passport photos of the applicant, certified by the health care professional who completed Part C of the application

Mail this application to:
TTC Support Person Assistance Card
1900 Yonge Street
Toronto, Ontario M4S 1Z2

Please allow 2 to 4 weeks processing time to receive the Support Person Assistance Card.