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  • Lifeline Voucher Program

    Online Reimbursement Form
  • Contract Information

    Mobility Specialist
    Jenny Rodriguez | 435-713-1449 | jennyr@brag.utah.gov

    Mobility Manager
    Alyssa Cronin | 435-713-1427 | alyssac@brag.utah.gov

    Mailing and Office Address
    BRAG: Lifeline Voucher Program
    170 North Main Street, Logan, UT 84321

    Overview

    This is the digital voucher sumission form. Paper copies are avaliable upon request. Vouchers may only be used for trips from approved catagories that can not be taken on public transit. Contact the mobility specialist prior to taking a trip for questions reguarding trip elibility. Ensure the form is complete before submitting.

    Participants are responsible to select drivers willing to accept mobility vouchers. BRAG encourages selecting trusted individuals who are legally licensed and insured.

    Drivers are responsible to submit voucher for reimbursement by the 3rd of each month. Drivers must verify the information on the vouchers is correct and complete.

    BRAG checks milage claimed prior to payment and mails checks to drivers. BRAG will not reimburse ineligible trips, incomplete vouchers, or if fraud is suspected.

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    • Program Sponsors 
    • WE THANK THE FOLLOWING ORGANIZATIONS FOR HELPING FUND THIS PROGRAM:

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