Behavior Health Service Transport Request Form
Illinois Patient Transport (IPT), transports involuntary patients, regardless of a client’s ability to pay. Involuntary transports are funded when utilizing Illinois Patient Transport, through a contract with the Illinois Department of Human Services.
To request a transport, FAX the following documents to 309-494-6227:
- Petition & Certificate (or Court Order)
- Hospital Face Sheet
- Illinois Patient Transport Request Form
Complete the transport request by contacting our Call Center at 309-999-4040, open 24/7 to gather information regarding the transport.
Transportation for voluntary and juvenile patients (12 and older) may be arranged on a case by case basis with a guarantee of payment or, for a better rate, your facility may wish to contract directly with Illinois Patient Transport.