To submit the RTN forms, you can call First Transit at (866) 503-9040, fax the form to (630) 873-1450, or mail it to 799 W Roosevelt Rd., Bldg 4, Suite 200, Glen Ellyn, IL 60137. Ensure all fields are completed accurately and attach any necessary supporting documentation. Submit the form within the required timeframe to avoid delays. Make sure to provide legible and detailed information to facilitate processing.

Ensure all RTN requests are submitted within the required timeframes for 2024 and 2025, as specified by First Transit guidelines.

The purpose of these forms is to facilitate the submission of RTN (Return Trip Number) requests to First Transit for non-emergency transportation needs. The forms include options for single trips and standing prior authorizations, providing detailed instructions on how to complete and submit them. They ensure that all necessary information is collected to arrange transportation efficiently.

• 1. Name of the Individual: Enter the first and last name of the individual requiring transportation.
• 2. Phone Number: Provide the contact phone number of the individual.
• 3. Address: Include the street, city, and ZIP code of the individual's address.
• 4. RIN Number: Enter the Recipient Identification Number (RIN) assigned to the participant.
• 5. Ambulatory or Wheelchair: Indicate whether the individual is ambulatory or uses a wheelchair.
• 6. Date of Appointment: Specify the date of the upcoming appointment.
• 7. Time of Appointment: Provide the time of the scheduled appointment.
• 8. Pick Up Address: Enter the address where the individual will be picked up.
• 9. Drop off Address: Provide the address of the facility where the individual will be dropped off.
• 10. Doctor's Name: Include the first and last name of the attending doctor.
• 11. Facility Name: Enter the name of the facility where the appointment will take place.
• 12. Facility Address: Provide the full address of the facility.
• 13. Doctor's Office Phone Number: Include the contact phone number of the attending doctor's office.
• 14. Reason for the Trip: Specify the reason for the trip with as much detail as possible.

Failure to submit the RTN form accurately and within the required timeframe may result in denied transportation requests and delays in arranging necessary appointments.

• Denial of Request: Your transportation request may be denied if the form is incomplete or not submitted on time.
• Delayed Appointments: Failure to arrange transportation in a timely manner may result in missed or delayed medical appointments.

• 1. Scheduling a Single Trip: Use the Single Trip form to arrange a one-time transportation request.
• 2. Standing Prior Authorization: Use the SPA form to arrange recurring transportation for ongoing treatments.
• 3. Emergency Transportation: Ensure emergency transportation requests comply with First Transit's guidelines.
• 4. Long-Term Care Facility Arrangements: Facilities can use the form to arrange transportation for residents.
• 5. Dialysis Center Appointments: Centers can use the form to coordinate transportation for patients.