UNMH / ABQ Express Shuttle Patient Transport Reservations
Use this form to book patient rides to anywhere in New Mexico from UNMH via ABQ Express Shuttle. Questions? Call 505-850-3880.
Name of UNMH staffer booking reservation: *
Email address of UNMH staffer booking reservation: *
Phone number of UNMH staffer booking reservation: *
Patient name: *
Date the patient needs to be picked up at UNMH (If less than 24 hours in advance, please call 505-850-3880 to confirm availability.): *
MM
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DD
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Time the patient needs to be picked up at UNMH: *
Time
:
Full address where the patient is to be delivered. (If they do not have a formal address, please enter latitude and longitude. If you need to look that up, click here: https://www.latlong.net/ ) *
What is the one-way mileage distance between UNMH and the address where the patient is to be delivered? Calculate here: https://www.google.com/maps/dir/UNM+Hospital,+Lomas+Boulevard+Northeast,+Albuquerque,+NM//@35.0881818,-106.6540005,13z/data=!4m9!4m8!1m5!1m1!1s0x87220cced1ec8075:0x21cf8aa3ba2d8d9a!2m2!1d-106.6189811!2d35.0881166!1m0!3e0 (Note: You can enter latitude and longitude as a destination if needed.) *
Multiply mileage by $2.25 and enter it here. (This is the trip cost that will appear on a later invoice.) *
Is there anything special we should know about the patient being transported?
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