Unenroll from the Access Flex Program

This form is to unenroll from the Access Flex Program. You only need to fill this form out if you were previously enrolled in the Access Flex program. If you have never filled out the Enrollment, please do not fill out this form. If you have questions about this form or the Access Flex Program, please reach out to Access Customer Service at cserv@accessla.org or call 800.827.0829

Name:

Access ID Number:

Home Address:

Email:

Smart Phone Number:

So we can improve the program, please indicate why (check all that apply)

Do not have access to smartphone or computer

Safety concerns

Vehicles are different than a typical Access vehicle

Driver courtesy/behavior

If you would like to provide additional detail of your reasons for opting out or have any questions or comments about the Flex Program, please type them here.

Unenroll from the Access Flex Program

(By choosing to unenroll, all of your Access rides will be provided by an Access service provider. We will no longer send your rides to a Access Flex provider.)

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Unenroll from the Access Flex Program - Access Services : ASI

Unenroll from the Access Flex Program