Skip to main content

Patient Transfer Quote

Please fill out the form below to request an appointment for a non emergency patient transfer. We will respond as soon as possible. Your transfer will not be booked until we contact you to confirm.

For urgent transfers, please contact us toll free at 1-866-777-2341.

"*" indicates required fields

DD slash MM slash YYYY
Transfer Time (leave if unsure)
:
Pickup Address*
Facility or Destination Address*

Transfer Details

Return Transfer?*
Are You travelling with escort?*
Oxygen Required?*
Weight over 250 lbs?*
Insurance (includes government departments)*
Type of payment?*

Pioneer Health Care servicing the Quinte Region, all of PEC, Belleville, Madoc, Bancroft and east to Ottawa and west to Toronto.

Return to top