REQUEST A RIDEThank you for choosing our transport services. We now offer you with the convenience of booking our services online. Simply provide the information below to ensure that you have a ride when you need it. Web SiteRequest a Ride First Name * Last Name * Phone * Email * Number of Passengers * Select the type of service you need * Walking (Ambulatory) Walking (With Assistance) Wheelchair (To Van Seat) Wheelchair (Confined) Pick-up Details Date * Time * Address * City and State * Zip Code * Drop-off Details Address * City and State * Zip Code * Special Instructions Is this Round-trip? * Yes No How did you hear about us Search Engine (Google, Bing etc.) Friend/Family Social Media (Facebook, Twitter etc.) Advertisements Coupon Code I accept LyfeOnWheels's Terms of Service *