I understand that to be certified to use MITSPlus under the guidelines of the American with Disabilities Act (ADA) I must have a disability which makes me unable to use MITS fixed route bus service. Unable means that this is impossible or it causes severe or continuing pain. I understand that discomfort, occasional pain, age, or distance to the nearest bus stop do not by themselves constitute an ADA eligible disability.
I hereby authorize the professional listed below to provide information to MITS regarding my ability to use MITS fixed route bus service. I understand that all information will be kept confidential.