IME Online booking

For urgent transportation (less than 24hr), contact 888-407-0114

Email Address

claim # / file ID*

Passenger name*

First Name
Last Name

Passenger tel #*

Alternate tel #

Passenger pick up address*

Street Address

Address Line 2

Appointment location(s)/time(s)*

Additional instructions (i.e. passenger doesn't speak English, uses folding wheelchair, etc.)

Bill to:*

First Name
Last Name

Phone*

Billing info*

Additional remarks