This form is to be completed by a licensed health care provider. It is the member’s responsibility to make sure this form is received by Veyo. The form will not be processed for the requested authorizations if it is missing medical necessity information or justification.

MTM Health acquired Veyo in 2022, which means the Connecticut NEMT program is now operated by MTM Health. Nothing is changing for members. You will still call the same phone number, and your benefits will remain the same. How Do I Know Where My Driver Is and What Do I Do If They Haven't Arrived?

If you do not have a screenshot, please fill out as much detail below to assist us with your trip rescue. Please be sure to include your email so we can respond quickly to your urgent request. Note: Only one form per member, this will allow an agent to work on your request quickly.

Veyo is excited to announce our acquisition by MTM. Nothing will change for our members, transportation providers, or medical facility partners at this time. You may continue to use your normal contact methods, forms, and ride scheduling processes.

How can we help you?

Please complete the below form to apply to be a Veyo Provider. This information is for internal Veyo use to understand current provider capacity and to determine if the service area and fleet composition of the Transportation Provider meet network needs.

Please instruct members to complete the forms and submit by fax. Sign in to Google to save your progress. Learn more.

Please send all requests to FAX: 860-724-2159 or email: [email protected]. To schedule or follow up on trip requests, please call 855.478.7350.

Request a return ride using the Veyo Member Portal.* Call Veyo at 866-907-1493 and follow the prompts. Cancel the ride by responding to the appropriate text message. Cancel the ride using the Veyo Member Portal.* † Members must be enrolled in Veyo's text messaging program. * Members must have registered to use the Veyo Member Portal.

Members or their representative can call Veyo at (866-907-1493 or TTY 711) to request a ride. This is the same number used to call the previous vendor. Members must schedule rides for routine appointments at least two business days in advance. If members need a ride to an urgent appointment, Veyo will arrange it for them in three hours or less.