Downloads

Click the Download or View button on the desired document. To print the document click View and click on the print button in-browser.


Reverse Sort Order

Standing Order Form

Standing Order Form
Download View

Single Trip Request Form

Single Trip Request Form
Download View

Physician Medical Necessity Form - wheelchair and BLS (stretcher)

Physician Medical Necessity Form - wheelchair and BLS (stretcher)
Download View

Physician Medical Necessity Form – Specialty Care Transport (SCTU)

Physician Medical Necessity Form – Specialty Care Transport (SCTU)
Download View

Physician Medical Necessity Form - Ambulatory or Mass Transit

Physician Medical Necessity Form - Ambulatory or Mass Transit
Download View

Key Telephone Numbers

The phone and fax numbers for reaching the LogistiCare Facilities department
Download View

Closest Provider Policy

Closest Provider Policy for New Jersey
Download View

Closest Provider Certification Form

Closest Provider Certification Form for New Jersey
Download View
Click the button below to download a free PDF reader if no PDF reader is currently installed.
Download Adobe Acrobat Reader

More Information for Facilities

Overview
Basic information about NEMT along with contact details for facilities
View
FAQ's
The most frequently asked questions we receive from facilities
View
Useful Links
A list of useful online resources for facilities
View
News Bulletins
Important recent updates and alerts for facilities
View
Reservations
Guidelines on making a reservation for a member
View