Abovas-background-temoignages

SERVICES

Areas Served

Baie-d’Urfé, Beaconsfield, Dollard-des-Ormeaux, Dorval, Kirkland, L’Île-Bizard – Sainte-Geneviève,

Pierrefonds-Roxboro, Pointe-Claire, Sainte-Anne-de-Bellevue, Senneville.

Service-accompagnement

Accompaniment

We help vulnerable West-Island residents who require accompanied-transport to get to their vital medical appointments on the Island of Montreal.

We are recognized by the Agence de la santé et des services sociaux de Montréal which provides us with a grant to help ensure our organization’s operation.

Registration

To make a request for accompanied-transport to a medical appointment, please fill in this form.

If you want the form by email write to info@abovas.com or call us at 514.694.3838. 

Service-frais

Fees

The beneficiaries of our service pay only a nominal fee to offset the costs for the use of our volunteer’s car.

For more information, please contact us

Accompaniment request form

General information

First Name*

Family Name*

Maiden Name

Sex*

Birth Date*

Language spoken*

Address*

City*

Postal code*

Phone*

Other Phone

Email

Emergency contact

Name*

Relationship*

Telephone*

Other telephone

Email

Beneficiary Status

Medical condition, reason for service request,etc.*

Details of appointment*

Date*

Time*

Hospital

Type of treatment/visit

Referral agency contact

Agency name

Referral contact

Phone

Fax

Email

THANK YOU TO OUR PARTNERS