Handicap Van Rental Reservation | Accessible Van Rentals

Handicap Van Rental Reservation Form

United Access is happy to be affiliated with a nationwide network of accessible van rentals, Accessible Vans of America, LLC, .

United Access rents lowered-floor mobility minivans in Missouri, Illinois, Tennessee, Texas, New Mexico, Oklahoma and Kansas. A valid credit card is required for all wheelchair van rentals.

To request a van rental online, complete the following form, print a copy for your records, and click the "submit" button. If you prefer not to register online, contact us at 877-659-1448.

Contact Information

First Name:*

Last Name:*

Address:

City:

State:

ZIP Code:

Phone:*

Email Address:

Insurance Information

Insurance Company:

Insurance Policy Number:

Rental Dates

Pick Up Date:*

Return Date:*

Submit