Request Transportation

Northern Virginia Veteran Transportation Service

VHBM is proud to offer safe and reliable transportation to veterans who require assistance traveling to and from VA health care facilities and authorized non-VA health care appointments. If you need assistance getting to and from your appointments, feel free to fill out the Transportation Request Form below or call our offices at (703) 867-2366 to schedule a ride.

This service is made possible by generous contributions from donors throughout the United States whom value our veterans’ service & efforts. If you would like to donate to this service and support our veterans in need, please consider making a donation online today or call our offices at (703) 867-2366 to donate by phone. Your donation will be tax-deductible and will directly impact the life of a vet. Thank you for your support!

Transportation Request Form

Complimentary ride service is available for veterans located within 25 miles of Jeffersonton, Virginia.
To be considered for transportation, fill out the form below and we’ll confirm your trip as soon as possible!

You can also request transportation by calling (703) 867-2366.

Your Name*
First Last
Your Phone*
Your Email*
We take your privacy seriously. View our Privacy Policy >>
Pickup Information:
Enter the time and place where we should pick you up.
Date Transportation is Needed:*
MM slash DD slash YYYY
Pickup Time:*

: Hours

Minutes

AM/PM
Pickup Address*
Street Address Address Line 2 City State ZIP Code
Destination Information:
Enter details about where we're dropping you off.
Is your drop-off location within 25 miles?*
- Yes, it's under 25 miles
- No, it's more than 25 miles
- Not sure
Please note: Destinations over 25 miles is outside of our preferred service area, however, we will consider all transportation request. All transportation is subject to approval & availability.
What's the name of your drop-off location?*
Do you know the physical address of your drop-off location?*
- Yes
- No
Drop-off Address*
Street Address Address Line 2 City State ZIP Code
Give us a short description of your transportation needs*
Terms & Submit
VHBM Transportation Terms:
Veterans Health and Benefits Management, LLC ('VHBM') provides safe and reliable transportation to veterans who require assistance traveling to and from VA health care facilities and authorized non-VA health care appointments.

Occasionally, VHBM may partner with service providers in local communities to serve veterans’ transportation needs. If we can't fulfill your transportation request, we will try to assist you by referring you to another recommended service provider.

VHBM tries to accommodate all transportation requests, however service is limited to availability and approval may be determined by, but not limited to: distance, weather conditions and road hazards.

Requests made within 72 hours of desired time may not be approved or may not be available. Please schedule your requests as early as possible to increase your chances of approval.

Title VI of the Civil Rights Act of 1964 states: “No person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” VHBM and its partners and grantees are committed to complying with the requirements of Title VI in all of its federally funded programs and activities.

VHBM RESERVES THE RIGHT TO CANCEL OR REFUSE SERVICE AT ANY TIME.
Terms Agreement:*
- I have read & agree with the terms

Request Transportation

Northern Virginia Veteran Transportation Service

Transportation Request Form

You can also request transportation by calling (703) 867-2366.

We take your privacy seriously. View our Privacy Policy >>

Pickup Information:

Destination Information:

Terms & Submit

VHBM Transportation Terms:

(703) 867-2366

William.Halevy@vhbm.org