Book Your RideSupporter "*" indicates required fields 1Patient Info2Doctor/Clinic Info3Recovery Location4Select And Book Your Service5Support & Safety Contacts6Payment Booking Number – Booking FormThis field is hidden when viewing the formBooking Form Entry IDThis field is hidden when viewing the formRide Time Report Entry ID Before You Book Please confirm the estimated pickup time with your clinic — not your procedure time. Recovery and discharge can take several hours, depending on the procedure and clinic flow. RideSupporter should be booked based on your expected time of discharge. In many cases, pickup may be 2–3 hours after your procedure start time. Please note: RideSupporter does not currently offer wheelchair-accessible or specialized support for medical conditions requiring trained medical staff. Service Area: We currently serve select Toronto M-area postal codes. Please check back as our service area is expanding. Patient Name* First Last Email* Phone Number* Doctor/Clinic Information You'll meet your RideSupporter for the first time at the clinic. They'll coordinate with the admin staff to be ready for your discharge and checkout. When you arrive at the clinic: Let the clinic administrator know that you have a RideSupporter meeting you. Provide them with the RideSupporter’s name and contact information from the email or text message you received. Your RideSupporter is a certified and trusted professional who will be waiting for you in the discharge area. You can relax knowing that you're in good hands—and so can your loved ones. Clinic NameIf there's no clinic name you may leave this empty.Doctor Name* First Last Clinic Email* Clinic Phone*Clinic Address* Street Address Suite Number City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Where Are We Taking You After Your Procedure? This field is for your Recovery Location — the place your RideSupporter is taking you after your appointment. It may be your home, a hotel, or a friend’s place. Wherever you'll be resting and recovering. RECOVERY LOCATION* Street Address Suite Number City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Is This Recovery Location:* Your Home A Friend or Relative's Home Hotel Other Make Sure You Have Access to Your Recovery Location When your RideSupporter meets you at the clinic for discharge and checkout, please ensure you have: Your recovery location key Any necessary access or room card Recovery Location Building Access If applicable, please provide the following details: Door location – front, side, or rear of building Access code – enter this in the form below Door Location Door Location Access Code Access Code ⓘ Medical Guidance & Choosing the Right Support It's always a good idea to consult with your doctor. Different procedures require different levels of attention, support, and recovery time. RideSupporter offers service durations of up to 5 hours, with every level of service prioritizing safety, comfort, and peace of mind. You can book your RideSupporter up to 4 days in advance. RideSupporter Recover Signature Service Book With 24 Hours Notice $129.99 Up to 3 hours of service Tax and transport extra Certified and Clinic supported Arrange and assist with transport to recovery location Post-care monitoring and comfortable setup Essential recovery assistance Best for minor procedures needing lighter support RideSupporter Last Minute Book With 3 Hours Notice $189.99 LIMITED AVAILABILITY Up to 3 hours of service Tax and transport extra Certified and Clinic supported Includes all RideSupporter Recover services Best for urgent unexpected needs RideSupporter Extend Book With 24 Hours Notice $169.99 Full 4-hour service duration Tax and transport extra Certified and Clinic supported Includes all RideSupporter Recover services Best for added flexibility and time based on Patient needs RideSupporter Max Book With 24 Hours Notice $209.99 Full 5-hour service duration Tax and transport extra Certified and Clinic supported Includes all RideSupporter Recover services Best for more involved recovery assistance needing all-day support Choose Your Service Level* Choose Your Service Level RideSupporter Recover RideSupporter Last Minute RideSupporter Extend Ride Supporter Max You Have Selected: RideSupporter Recover – Our Signature Service RideSupporter Recover is designed for clients recovering from minimally invasive procedures. This service provides up to three hours of support, including safe transportation, assistance settling in at your recovery location, and ensuring you are comfortable and prepared for rest. Once you are safely settled, your RideSupporter's role is complete, even if the full three hours have not elapsed. Our focus is always on your safety, comfort, and a smooth transition home. A Safe Return Fee of up to $20 may apply to ensure your RideSupporter's safe return after providing you with care. Full description of RideSupporter Services. You Have Selected: RideSupporter Last Minute RideSupporter Last Minute provides urgent recovery support with minimal advance notice. It offers the same high level of care and attention as RideSupporter Recover, ensuring your safety, comfort, and a smooth return home. Designed for clients recovering from minimally invasive procedures. This service provides up to three hours of support, including safe transportation, assistance settling in at your recovery location, and ensuring you are comfortable and prepared for rest. Once you are safely settled, your RideSupporter's role is complete, even if the full three hours have not elapsed. Our focus is always on your safety, comfort, and a smooth transition home. A Safe Return Fee of up to $20 may apply to ensure your RideSupporter's safe return to their destination after providing you with care. Looking for Last Minute before 10:00 AM? You must book a 10:00 AM slot—only 10:00 AM signals early availability. If there are no 10:00 AM time slots please check again later. Text your assigned RideSupporter right after booking. Ask if they’re available earlier. They’ll confirm with you directly. If not, they’ll cancel the booking at no charge so you can try again. Full description of RideSupporter Services. Important: Due to the urgent nature of this service, a $100 cancellation fee applies once booked. You Have Selected: RideSupporter Extend RideSupporter Extend is designed for clients who may require a longer observation period following their procedure, particularly when stronger medications are used. Your RideSupporter is booked to assist you for a full four hours, providing monitoring, comfort support, and assistance as you recover. A Safe Return Fee of up to $20 may apply to ensure your RideSupporter's safe return to their destination after providing you with care. Full description of RideSupporter Services. You Have Selected: RideSupporter Max RideSupporter Max provides our longest available duration of post-procedure support. Your RideSupporter is booked to remain with you for a full five hours, offering monitoring, comfort assistance, and support throughout your recovery. If a designated caregiver, family member, or friend arrives during this time, your RideSupporter will continue to assist and help facilitate a safe and smooth handoff, while remaining available for the full duration. A Safe Return Fee of up to $20 may apply to ensure your RideSupporter's safe return to their destination after providing you with care. Full description of RideSupporter Services. 📆 Important: Choosing Your Pickup Time Please book based on your expected discharge time, not your procedure time. Ask your clinic when they expect you'll be ready for pickup. Your RideSupporter will be on standby and can adjust your pickup by up to 1 hour earlier or later if your clinic schedule changes. Changes of up to 1 hour earlier or later can be accommodated. More than 1 hour may require rebooking and a cancellation fee. You can book up to 4 days in advance. If no times are available, check back—new slots may appear. SSA Recover*SSA Last Minute*SSA Extend*SSA Max*This field is hidden when viewing the formTeam Member Email – RecoverThis field is hidden when viewing the formTeam Member Email – Last MinuteThis field is hidden when viewing the formTeam Member Email – ExtendThis field is hidden when viewing the formTeam Member Email – MaxThis field is hidden when viewing the formAssigned Team Member Email Buffer Time & Continuity of Care Your RideSupporter's service begins 1 hour before your scheduled pickup time. This built-in buffer ensures they’re ready if you’re discharged early or if your clinic runs ahead of schedule. Important: The calendar shows your pickup time, but your service actually starts one hour earlier—and ends one hour earlier than the displayed time. Example: If your booking shows 1PM to 4 PM, your RideSupporter will be with you from 12 PM to 3 PM. To ensure a smooth transition from RideSupporter to your next caregiver: Plan for your RideSupporter's service to end one hour earlier than displayed. Schedule any family members or caregivers to arrive by the actual end time. If needed, your RideSupporter will stay until it’s safe to leave or another caregiver arrives. Support Contacts & Communication RideSupporter gives you the option to keep loved ones in the loop—whether that’s for peace of mind or to help coordinate care. Note: You can list the same person for all roles, choose different contacts, or skip the optional ones altogether—whatever works best for you. Emergency Contact (Required): Someone we can call if a serious issue arises during your appointment. Peace of Mind Contact (Optional): A person you’d like us to text with a brief update while you're in our care. Recovery Care Contact (Optional): If someone will take over your care afterward, we’ll coordinate timing with them. We’ll only reach out when necessary or as you’ve requested. Emergency Contact Name* First Last Emergency Contact Phone* Peace of Mind Contact - Optional If you'd like, your RideSupporter will send a quick update to someone you trust—just to let them know everything’s going smoothly. This is entirely optional. The contact will receive a brief text message once you’re settled at your Recovery Location. No medical details will be shared—just a reassurance that you’re doing well. Only one message will be sent. This service is designed to give your loved ones peace of mind—without adding stress or responsibility to your day. Same As Emergency Contact? Yes Peace of Mind Contact Name First Last Peace of Mind Contact Phone Recovery Care Contact - Optional If someone else will be arriving to continue your care—such as a family member or friend—your RideSupporter can help coordinate a smooth hand-off. Your RideSupporter will stay with you until this contact arrives or until it's clearly safe to finish your service and leave. This ensures you're never left unsupported during recovery. Same As Emergency Contact? Yes Same As Peace of Mind Contact? Yes Recovery Care Contact Name First Last Recovery Care Contact Phone ⓘ What You're Paying For Final Total = Service + Transport + Safe Return Service: Loading... Transport: Most clients only need one ride—from the clinic to your Recovery Location. If more rides are needed, your RideSupporter will arrange them and we’ll forward the full at-cost receipts afterward. Safe Return: A fee of up to $20 may apply toward your RideSupporter's return Uber fare after caring for you. The final charge will show the actual trip cost (up to $20), and your Uber at-cost receipt. See the full policy here. After your RideSupporter completes the service, your total will be finalized. Our flat Booking Fee is $9.99. You’ll receive a full receipt by email. Estimate Your Transport Cost Or Use The Uber Estimator Your RideSupporter will be with you to handle all transportation, so you won’t need to pay anyone directly. There’s no need to fuss with apps or swipe your card—everything is arranged to keep your experience smooth and stress-free. All Uber transport is billed at-cost. Use the estimator below to see what to expect—no surprises, no markup. Open Uber Estimator Estimated Transport CostEnter what the Uber Estimator gave or your own best guess. Estimated Costs will update in the Booking Summary. Pre-Authorized Deposit Pre-Authorized Hold A temporary hold of $400.00 CAD is placed on your card to reserve your RideSupporter and protect against rare additional costs. This ensures we can: Cover extended overtime if your recovery takes longer than expected Include additional transport if you require more than expected Guarantee your RideSupporter is secured for your booking This is not a charge. The final amount is charged after your service is complete. This field is hidden when viewing the formClient Checkout FieldsDo not change field labels. They are hard coded in Functions PHPThis field is hidden when viewing the formBase FeeThis field is hidden when viewing the formDeposit AmountThis field is hidden when viewing the formSubtotalReason For Overtime*In No please explain.*If Yes please explain.*If No please explain.*If Yes please explain.*If Yes please explain.*If Yes please explain.*If Yes please explain.*If No please explain.*If Yes please explain.*This field is hidden when viewing the formPSW Notes*This field is hidden when viewing the formPSW Notes Upload Drop files here or Select files Max. file size: 256 MB. This field is hidden when viewing the formReceipt FieldsThis field is hidden when viewing the formReceipt: Date of service Month Day Year This field is hidden when viewing the formPickup Date & TimeDisplays the confirmed pickup date & time based on selected RideSupporter service.This field is hidden when viewing the formPSW NameThis field is hidden when viewing the formPSW EmailThis field is hidden when viewing the formReceipt: PSW Overtime HoursThis field is hidden when viewing the formReceipt: PSW Overtime FeeThis field is hidden when viewing the formPromoThis field is hidden when viewing the formReceipt: RideSupporter TotalThis field is hidden when viewing the formTransport SectionThis field is hidden when viewing the formReceipt: Transport to Recovery Location FeeThis field is hidden when viewing the formTransport to Recovery Location ReceiptMax. file size: 256 MB.This field is hidden when viewing the formSafe Return Fee ReceiptMax. file size: 256 MB.This field is hidden when viewing the formReceipt: Additional Transport FeeThis field is hidden when viewing the formAdditional Transport Fee ReceiptMax. file size: 256 MB.This field is hidden when viewing the formReceipt: Transportation TotalThis field is hidden when viewing the formReceipt: TotalThis field is hidden when viewing the formPSW SectionThis field is hidden when viewing the formPSW Share of Service ChargeThis field is hidden when viewing the formPSW Share of Overtime ChargeThis field is hidden when viewing the formPSW Uber OverageThis field is hidden when viewing the formPSW SubtotalThis field is hidden when viewing the formPSW FinesThis field is hidden when viewing the formPSW BonusThis field is hidden when viewing the formPSW Total PayoutThis field is hidden when viewing the formAdmin SectionThis field is hidden when viewing the formTotal Direct CostsThis field is hidden when viewing the formGross MarginThis field is hidden when viewing the formNotes SectionThis field is hidden when viewing the formClient NotesThis field is hidden when viewing the formClient Notes Upload Drop files here or Select files Max. file size: 256 MB. This field is hidden when viewing the formAdmin NotesThis field is hidden when viewing the formAdmin Notes Upload Drop files here or Select files Max. file size: 256 MB. Credit Card*Payments powered by ©Stripe, Inc. Terms of Service* I agree to the Terms of ServiceCancellation Policy*I understand that submitting this form confirms my RideSupporter booking. If I need to make changes, the original booking will be cancelled and I must rebook, subject to availability and applicable fees. - If my clinic reschedules my appointment by 1 hour or less, I must contact my RideSupporter directly. They are able to accommodate the change. - If the appointment is rescheduled by more than 1 hour, I must also contact my RideSupporter directly. They will try to accommodate, but availability is not guaranteed. If they're unable, the booking must be cancelled and rebooked. The standard cancellation policy applies. - Cancellations with 24+ hours’ notice are fully refundable. - Cancellations with less than 24 hours’ notice incur a $100 fee. - If the RideSupporter ends the service for valid cause, the full fee still applies. I agree to the Cancellation Policy