Share A Fare Application

* * For questions about Share A Fare in Kansas City, Missouri please click or call 816-842-9070.

Certifying authority:

Please complete the below online application form for the Share A Fare program for your patient/client/consumer. Alternatively, download .pdf version of application.

If providing a post office box as a primary mailing address, we also require, for geographical purposes, a physical street address of residency.  Without this information, we will be unable to process your application.

Applicant's Information
Certifying Authority's Information
This section to be completed by Doctor, Nurse, Optometrist, or Rehabilitation Counselor