My Freedom Application Upload Form

Please use this form to upload files related to a My Freedom application, such as:

• Medical Verification Form that has been completed and signed by a physician
• A scanned document or photos of the front and back of the client's IndyGo Access Card
• A scanned document of a printed application form

Please note that CICOA must receive a completed application along with the Medical Verification Form or IndyGo Access Card.