Accessible Ride Share Vehicle ADA Compliance Form

Vehicle & Operator Information

Company Name Vehicle ID / Plate Number Driver Name Inspection Date

Wheelchair Accessibility

Ramp or Lift Present Yes No Adequate Space for Wheelchair (30” x 48” min) Yes No Wheelchair Securement Devices Installed Yes No

Vehicle Features

Grab Handles/Bars Installed Yes No Audio/Visual Announcement System Yes No Passenger Restraint System for Wheelchair Users Yes No

General Accessibility

Service Animal Allowed Yes No Accessible Controls (Door, Lift, etc.) Yes No

Comments / Notes