[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-160294-en":3,"doc-seo-160294-105":30,"detail-sidebar-cat-0-en-105":90},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},160294,137441390410,"Hazel","https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984",7,"Healthcare","Central West Virginia Transit Authority（CENTRA）Complementary Paratransit Application - Application Form","Application form for requesting Central West Virginia Transit Authority (CENTRA) complementary paratransit service. Collects applicant identity and addresses, telephone contact, birth date (optional), emergency contact details, and whether a personal care attendant (PCA) is needed, including PCA information. Includes questions about use of a service animal, additional assistance, mobility limits such as stairs and travel distance without help, the disability preventing fixed-route use, and related effects. Captures accessibility aids, wheelchair or scooter dimensions and occupied weight, requires certification signatures, and authorizes CENTRA to contact an authorized individual; revised October 2020.","Application for  \nCentral West Virginia Transit Authority (CENTRA) Complementary Paratransit Service  \nPlease complete and sign this application in ink. Only completed applications will be  considered. There are four (4) pages.  \n1. Name (please print)    \n2. Mailing Address  City   State   Zip    \n3. Street Address   \nCity   State   Zip    \n4. Directions to the home   \n5. Telephone (home) (work)   (cell)   \n6. Date ofBirth   (optional)  \n7. Emergency Contact name    \n8. Emergency Contact number(s)    \n9. Do you need to use the services of a personal care attendant (PCA) to ride the bus?  \nPlease circle. YES (see below) NO  \nIf yes, please provide contact information for your PCA.  \nPCA name    \nPCA address   City   State   Zip   PCA phone number(s)   \n\n|  |\n| --- |\n|  |\n|  |\n\n11. Do you use a service animal? Please circle. YES NO  \nIf yes, what is the animal and what is the animal’s function?    \n12. Do you need any other assistance? Please circle. YES NO  \nIf yes, please explain.    \n13. Can you climb three (3) twelve (12) inch steps without assistance? Please circle.  \nYES NO  \n14. What is the maximum distance you can travel without assistance of another person?  (In feet)  \n15. Do hills or steps affect this distance? Please circle. YES NO  \n16. What is the disability that prevents you from using our fixed route services?  \n\n|  |\n| --- |\n|  |\n|  |\n\n\n|  |\n| --- |\n|  |\n\n18. Are there other effects of your disability we should be aware of?  \n\n|  |\n| --- |\n|  |\n\n19. Is this condition temporary? Please circle. YES NO  \n20. Do you use any of the following aides? Please circle all that apply.  \nMANUAL WHEELCHAIR CANE  \nPOWERED WHEELCHAIR WALKER  \nPOWERED SCOOTER CRUTCHES  \n21. If you use a wheelchair or powered scooter, what are its dimensions when measured two (2) inches off the ground?    \n22. What is the total weight when occupied (occupant plus wheelchair or scooter)?  \n (in pounds)  \nI hereby certify that the information provided in this application has been answered to the best of my ability and that the information contained in the application is accurate and true.  \nSignature   Date   \nIf this application has been completed by someone other than the person requesting certification, that person must complete the following:  \nName   Address   City   State   Zip   Relation to applicant   Phone number(s)   Signature   Date   \nWho may CENTRA contact that is familiar with your disability and is certified and authorized on your behalf to provide personal information which may be required to complete the final process of this Complementary Paratransit Application?  \nName   Address   City   State   Zip   Phone number(s)    \nI hereby give permission for the Central West Virginia Transit Authority (CENTRA) to contact the above listed individual concerning my disability.  \nSignature   Date   \nIf you have questions concerning this application, please contact CENTRA at 304.623.6002 daily from 8:00 am until 4:00 pm. Thank you.  \nRevised October 2020","cbCaibOujUrJY09H","https://ap.wps.com/l/cbCaibOujUrJY09H","pdf",15019,1,4,"English","en",105,"# Application Information\n## Applicant & Emergency Contacts\n## PCA and Service Animal Details\n## Mobility and Disability Questions\n# Certification and Authorization","[{\"question\":\"What information must be completed on the CENTRA complementary paratransit application?\",\"answer\":\"The form collects applicant name and addresses, telephone contact, emergency contact information, whether a PCA is needed (and PCA contact details if yes), and information about service animals and other needed assistance.\"},{\"question\":\"How does the application assess mobility and eligibility?\",\"answer\":\"It asks if the applicant can climb three 12-inch steps without assistance, the maximum distance the applicant can travel without another person, whether hills or steps affect that distance, and the disability that prevents use of fixed-route services.\"},{\"question\":\"What additional details are required for wheelchairs or scooters?\",\"answer\":\"If using a wheelchair or powered scooter, the applicant must provide its dimensions measured two inches off the ground and the total occupied weight in pounds.\"}]","Central West Virginia Transit Authority（CENTRA）Complementary Paratransit Application - Application Form | PDF",1788053610,10,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":85,"head_meta":87,"extra_data":89,"updated_unix":28},"central-west-virginia-transit-authority-centra-complementary-paratransit-application-application-form","",{"@graph":36,"@context":84},[37,53,67],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":21},"https://docshare.wps.com/document/central-west-virginia-transit-authority-centra-complementary-paratransit-application-application-form/160294/",{"url":52,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":61,"encodingFormat":60,"isAccessibleForFree":62,"interactionStatistic":63},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-08-30",true,{"@type":64,"interactionType":65,"userInteractionCount":4},"InteractionCounter",{"@type":66},"ViewAction",{"@type":68,"mainEntity":69},"FAQPage",[70,76,80],{"name":71,"@type":72,"acceptedAnswer":73},"What information must be completed on the CENTRA complementary paratransit application?","Question",{"text":74,"@type":75},"The form collects applicant name and addresses, telephone contact, emergency contact information, whether a PCA is needed (and PCA contact details if yes), and information about service animals and other needed assistance.","Answer",{"name":77,"@type":72,"acceptedAnswer":78},"How does the application assess mobility and eligibility?",{"text":79,"@type":75},"It asks if the applicant can climb three 12-inch steps without assistance, the maximum distance the applicant can travel without another person, whether hills or steps affect that distance, and the disability that prevents use of fixed-route services.",{"name":81,"@type":72,"acceptedAnswer":82},"What additional details are required for wheelchairs or scooters?",{"text":83,"@type":75},"If using a wheelchair or powered scooter, the applicant must provide its dimensions measured two inches off the ground and the total occupied weight in pounds.","https://schema.org",{"og:url":52,"og:type":86,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":88,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":91},[92,96,100,104,109,114,117,122,127,130,133],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":93,"show_sort_weight":94,"slug":95},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":97,"show_sort_weight":98,"slug":99},"Literature",80,"literature",{"id":21,"doc_module":4,"doc_module_name":46,"category_name":101,"show_sort_weight":102,"slug":103},"Exam",70,"exam",{"id":105,"doc_module":4,"doc_module_name":46,"category_name":106,"show_sort_weight":107,"slug":108},5,"Comic",60,"comic",{"id":110,"doc_module":4,"doc_module_name":46,"category_name":111,"show_sort_weight":112,"slug":113},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":115,"slug":116},40,"healthcare",{"id":118,"doc_module":4,"doc_module_name":46,"category_name":119,"show_sort_weight":120,"slug":121},8,"Research & Report",30,"research-report",{"id":123,"doc_module":4,"doc_module_name":46,"category_name":124,"show_sort_weight":125,"slug":126},9,"Religion & Spirituality",20,"religion-spirituality",{"id":125,"doc_module":4,"doc_module_name":46,"category_name":128,"show_sort_weight":125,"slug":129},"World Cup","world-cup",{"id":29,"doc_module":4,"doc_module_name":46,"category_name":131,"show_sort_weight":29,"slug":132},"Lifestyle","lifestyle",{"id":134,"doc_module":4,"doc_module_name":46,"category_name":135,"show_sort_weight":105,"slug":136},19,"General","general"]