Please complete the form below to request non-emergency medical transportation. A CharmMed team member will review your request and contact you to confirm availability and pricing before transportation is scheduled.
Need transportation within 48 hours? Call us directly at 410-205-6264 so we can confirm availability as quickly as possible.
When completing the form:
Under Service Details, choose Wheelchair or Ambulatory. If the rider walks independently or uses a cane, walker, or rollator, select Ambulatory.
Use the Additional Notes section to let us know if the rider needs CharmMed staff to accompany them into the appointment or stay during the visit.
Include any stairs, access instructions, parking details, or mobility concerns that may affect the trip.
Submitting this form does not confirm transportation. CharmMed will contact you to confirm availability, trip details, support needs, and pricing before transportation is scheduled.