Event Sign Up Sheet | Track It Forward

Drive client to doctor's office

Tuesday, July 16 2019

# of Drivers needed - 1
Pick up time - 1:00pm
Pick up location - 670 Clinton Ave, Bridgeport CT
Responsible CIRI staff member: Agnes Farkas
Contact Phone Number (cell, please): 203-584-4797

Destination with full name and address:
Eye Physicians + Surgeons PC
3502, 202 Cherry St.
Ph- 203-878-1236
Approximate duration of assignment: 1 hour
Appointment Time: 1:30pm
Number of people to be transported: Solomon Mehari Abraham, Zerie Zerie Interpreter

Names, Ages, Genders, Origin Country, and Languages (including any English) of Passengers:
Solomon Mehari Abraham, Eritrean 54, speaks Eritrean no English
He needs surgery on his eyes possibly for cataract. Interpreter will be accompanying him.

Instructions:
Please stay with client at destination and bring back to office when finished. Appointment should
be approximately 1 hour. Driver does not need to go inside with client as he will have the interpret
with him that goes inside

1:00pm
Driver
0 / 1

Contact the event organizers: Ryan Roberts