Emergency Ride Home Program – Lyft Pass Registration Form – Transportation Services

Complete this form to register for an Emergency Ride Home using a Lyft Pass code. A limited-use ride code will be emailed to you email after submitting the form.

By signing up through this form you agree to the restrictions of the Emergency Ride Home program as outlined on this webpage and on the Emergency Ride Home program webpage.

Emergency Ride Home Lyft Registration

Name

This field is for validation purposes and should be left unchanged.

Do you have a valid Wiscmail or UW Health email address?

Yes

Enter your Wiscmail or UW Health email address.(Required)

Enter Email Confirm Email

You will only be able to submit this form with a valid Wiscmail or UW Health email address.

Name(Required)

First Last

What is your department, school, or college?(Required)

What is your phone number?(Required)

What is your work address?(Required)

Street Address Address Line 2 City State ZIP Code

If you are a UW-Madison or UW Health employee without access to a wisc.edu or UW Health email address and would like to use the ERH program, please call customer service at (608) 263-6667 or email Commuter Solutions.