Register Carer

Use this page to register if you are a carer or companion who is registering a person for whom you are responsible or who you assist and who wishes to use ReadiBus and for whom you will be making booking requests for journeys on their behalf.

Please read ‘who qualifies?’ before you complete this form. Please take care in completing the form – especially when completing details such as the bus pass number.

All applications are reviewed before activation.

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About You (The Carer/Responsible Adult)

First name *

Last name *

Email *

Email

Confirm Email

Username *

Password *

Password

Confirm Password

Phone number

Mobile Phone number

Pass? user Does

About the User

First name *

Last name *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Secondary (Emergency) Contact Name

Here you should enter the name of the person Readibus should contact in the case of problems or emergencies or if we are having difficulty contacting you

Secondary Contact Telephone Number

Please enter the usual phone number for your secondary contact (this can be a mobile number)

Date of Birth *

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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 needs to use ReadiBus or the difficulties the user has getting out and about

Readibus is a service specifically for people with mobility difficulties that mean it isn’t possible or practical to use scheduled public transport services. Please enter the nature of the user’s mobility impairments here.

Will you or another carer normally accompany the user on ReadiBus journeys?

• Yes

We need to know this so we can plan the space on buses effectively for everyone’s benefit

Does the user use any of the following?

• Walking stick
• Shopping trolley
• Walking frame

We need to know this so we can plan the space on buses effectively for everyone’s benefit

Does the user use a wheelchair? *— Select Choice —NoYes – ElectricYes – Manual (can be folded)Yes – Manual (cannot be folded)

Please select from the list

Would the user stay in the wheelchair during their journeys?

• Yes

Please state the make and model of the wheelchair

Does the user have a concessionary travel bus pass? *

• Yes
• No

Readibus is paid for journeys of those you hold concessionary passes through that service, so we need to know if you have one.

Which Local Authority Issues Your Pass?ReadingWokinghamWest BerkshireSouth Oxfordshire

Please enter their bus pass number

Does your bus pass entitle a companion to travel with you?

• Yes
• No

Readibus is paid for journeys of those you hold concessionary passes through that service, so we need to know if you have one.

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

Please state any other conditions that affect your mobility or or which your believe we should be aware. We need this information to determined how your needs can best be met by Readibus.

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