Request A Reservation

Medlife Transportation is committed to servicing the community and our customers by providing high quality professional non-emergency transportation within the Clark County and Nye Counties and also out of state of Nevada.

NEMT Reservation in Las Vegas, Nevada

To submit a reservation request to Medlife Transportation, please fill out the form below for non-emergency medical transportation in Las Vegas Nevada:

First Name

Last Name

Phone

Relationship to Patient

Patient's Name

Patient's Age

Patient's Weight

Service

Transport

One Way Round-trip

Does patient requires oxygen

Yes No

Details

Pick Up Date

Pick Up Time

DNR(do not resuscitate)

Yes No

If you requested DNR, please upload the legal documents here

Return time...

Pick Up Location Facility

Pick Up Address

Address of Destination

Additional Information

Transport Date

Street Name

City, State

Country

Receiving Facility Name

Additional Information

After completing the form and sending it, a member of our team will be in touch shortly to confirm your reservation.

Non-Discrimination Policy

Medlife Transportation, which offers non-emergency medical transportation in Las Vegas Nevada, provides equal employment opportunity and client services. In observance of Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, the company protects employees and clients from unlawful discrimination against race, gender, disability, color, national origin, age, religion, sexual orientation, ancestry or citizenship.

Request A Reservation

NEMT Reservation in Las Vegas, Nevada

After completing the form and sending it, a member of our team will be in touch shortly to confirm your reservation.

Non-Discrimination Policy

Navigation