Transportation Request Form
  • Transportation Request Form

    Please follow the guidelines stated below!
  • Walton Empowers Transportation Request Guidelines:

    At Walton Empowers, we strive to ensure that all transportation needs are met in a timely and organized manner. To maintain efficiency and accommodate as many requests as possible, we ask that peers follow these guidelines when submitting transportation requests

    Transportation Guidelines

    • To qualify for transportation services, peers must:
    • Be meeting with their Peer Coach for individual support
    • Attend at least one of Walton Empowers’ regularly scheduled weekly support groups
    • Reside & be transported within Walton County. Transporation outside of Walton County will only be provided with prior approval.  

      These requirements ensure that transportation services are prioritized for peers who are actively engaged in their recovery journey and committed to utilizing the support resources available.


      1. Transportation Availability
      Transportation services are available Monday through Friday, from 10:00 AM to 4:00 PM, with 4:00 PM being the latest scheduled appointment time. Transportation is also available for Walton Empowers–facilitated meetings upon request.

      2. Responsibility for Requests
      It is the responsibility of each individual to submit transportation requests. Please do not assume transportation will be arranged based on appointment notifications. If you need assistance completing a request, our staff will gladly help if you call during business hours.

      3. Advance Notice Requirement
      All transportation requests must be submitted at least 72 hours in advance. Requests not submitted within this timeframe will be automatically denied. Scheduling is completed on a first-come, first-served basis.

      4. Last-Minute Requests
      We understand that emergencies may occur. Last-minute requests must be called in during normal business hours (10:00 AM – 5:00 PM). If staff is able to accommodate the request, it will be confirmed. Requests outside of this timeframe will not be considered and will automatically be denied.

      5. Cancellation Policy – Two Strikes Rule
      If transportation needs to be canceled, please provide as much notice as possible. Failure to notify staff in advance, or being absent at the scheduled pickup time, will result in a “strike.” After two strikes, transportation services will be suspended for one week. Each additional strike will increase the suspension period by one week.

      Important Note: If a transportation request is denied by staff, and a peer attempts to bypass the decision by seeking approval from another staff member, transportation privileges will be suspended for one week.

      6. Additional Stops
      The only additional stops permitted are for prescription drop-off or pick-up.

      7. Children Policy
      While we welcome families, please note that Walton Empowers transportation services are not a childcare service. Parents and guardians are required to bring their children inside with them. Our staff and drivers are not responsible for supervising children.

      8. Additional Information
      Walton Empowers provides a weekly grocery store run to Walmart on Mondays at 1:00 PM. Individuals wishing to participate must complete a transportation request form in advance to be added to the store run schedule.

      Thank you for adhering to these guidelines and helping us provide effective and reliable transportation services to our peers. If you have any questions or need assistance, please contact our office.

    Transportation Services Liability Waiver and Assumption of Risk Agreement

    Please read this form in its entirety and be aware that in consideration for Walton Empowers, INC. Transportation Services, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injured, damages, or loss which you might sustain as a result of said services, including but not limited to, vehicle operations and boarding and exiting the vehicle.

    By submitting this form you recognize and acknowledge that Walton Empowers, INC. is neither a common carrier nor in the business of providing transportation to the public. I further recognize and acknowledge that there are certain risks of physical injury to vehicle passengers, and I voluntarily agree to assume the full risk of all injuries, damages, or loss, regardless of severity, that I may sustain as a result of participation in any and all activities connected with or associated with receiving transportation services, including but not limited to injuries, damages, and loss arising out of negligent operation or supervision of the vehicle. I further agree to waive and relinquish all claims I may have (or accrue to me) against Walton Empowers, INC. including its respective official, agents, volunteers, and employees (hereinafter collectively referred to as "Party").

    By submitting this form you hefully release and forever discharge the Party from any and all claims for injuries, damages or loss that I may have, which may accrue to me arising out of, or in any way associated with said transportation services.

    By submitting this form you further agree that this agreement shall be governed by the State of Georgia.

    Contact us: 770-266-6788

  • Format: (000) 000-0000.
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