Register as a local authority, agency or care assistant

Use this page to register if you are an agency or local authotity who is registering a person for whom you are responsibile or who you assist and who wishes to use Readibus. You will make e booking requests for journeys on their behalf. Please read 'who qualiifies?' before you complete this form. Please take care in completing the form - especially when completing details such as the bus pass number!

The ? symbols contain helpful tips on completing the form.

DO NOT use this page if you are a carer or companion who will make requests on the user's behalf.

About You (The Organisation, Personal Contact)

Organisation Name*

Department/section

First Name*

Last Name*

Email Address*

Confirm Email Address*

Telephone Number*

Mobile Number

About The User

First Name*

Last Name*

Address Line 1*

Address Line 2

Address Line 3

Town*

County*

Post Code*

Secondary Contact Name

Secondary Contact Telephone Number

Date of birth*

Ethnicity

How did you find out about ReadiBus?*

How did the passenger previously travel before using ReadiBus?*

About The User's Abilities

Please state the reason(s) the user need to use ReadiBus or the difficulties the user has getting out and about.*

Will the user normally accompanied by a carer on ReadiBus journeys?

Does the user use any of the following?

Walking Stick Shopping Trolley Walking Frame

Does the user use a wheelchair?*

Does the user have a concessionary travel bus pass?*

Yes
No

Are there any other details/medical requirements concerning the user of which you believe ReadiBus should be made aware?

Register as a local authority, agency or care assistant

Protecting You

Contact Us

Accessibility & copyright

Share this page