Serving patients across all of Illinois
Welcome to the Modivcare Member web site for Illinois. Currently this site hosts information for members about how to get a ride if they have no other way to get a ride. The forms on this site are stored in PDF format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at www.get.adobe.com/reader.
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Forms
This is the log sheet for recording scheduled appointments. When completed this sheet is submitted for reimbursement. (Spanish)
This outlines the Mileage Reimbursement Program. (Spanish)
This outlines the Mileage Reimbursement Program.
This is the log sheet for recording scheduled appointments. When completed this sheet is submitted for reimbursement.