Print Form
Office Use Only
VALIDATION NUMBER:
Parking and Transportation
University of Virginia Department of Parking and Transportation
Phone: 434-924-7231
Fax: 434-924-3980
Health System Patient Parking Validation Request Form
for Health System Departments
The University of Virginia Department of Parking and Transportation is able to setup garage validation billing
accounts for Health System Departments to cover the cost of their patients and patients' visitors parking fees. Please
visit the Parking and Transportation website for current parking rates and additional information about parking
validations. These validations do not cover visitors of the Health System, vendors, students, residents, or employees.
Requests for Patient Parking Validations must be approved by the Health System Parking Office.
Department:
Contact:
Mailing Address:
Phone Number:
E-Mail Address:
PTAO:
Department Head:
Date:
Signature of Department Head:
Estimated Number of Guests Per Month:
Please Indicate Parking Facility:
11th Street Garage
( )
( )
Lee Street Garage
Note: The Lee Street Garage is for patient and patients visitor parking only.
Form completed by: (please print)
Signature:
Date:
Patient Parking Validation Approval
Completed applications should be faxed or mailed to the Health System Parking Office for approval prior to being
submitted to Parking and Transportation's Facilities Operations division.
Health System Parking Office Fax: 434-924-9967 Phone: 434-924-5147
PARKING & TRANSPORTATION OFFICE USE ONLY
C-UID:
E-UID:
HEALTH SYSTEM PARKING OFFICE USE ONLY
_____Request Approved
Form last updated 4/19/2010
_____Request Denied