May 21, 2022

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LIFT & FIXED ROUTE COMMENTS FORM

LIFT & FIXED ROUTE COMMENTS FORM

user generated form to submit Comments, Complaints & Compliments

Step 1 of 3

33%

Date*

MM slash DD slash YYYY
Name:*
Type of Response Requested:*
- Phone
- Email
- Letter
- None
Address*

Street Address

City

State

ZIP Code
Phone*
Email*
Reason for Call
- Customer Comment/FYI
- Compliment
- Complaint

Service Type
- Fixed Route
- CC
- Lift
- Nightline
- Shelter
- Other (Explain in Custome Comments)
Date of Incident*

Month

Day

Year
Time of Incident*

:
Hours

Minutes

AM/PM
Route Number:*
Vehicle Number:
Direction: (outbound, inbound, northbound, southbound, eastbound, westbound)
Driver Description:
Pickup Address:*
Pickup Location Name:
Drop-Off Address*
Drop-Off Location Name:
Complaint:*
- Not on Time
- Driver Attitude
- Pass Up
- Maintenance
- No Show
- Reckless Driving
- Customer Service Rep
- Incorrect Info/Order
- Route Driven Wrong
- Scheduling/On-Board Time
Other:

Customer Comments:
Person Filing Complaint:
- Rider
- Driver
- Other
Other Contact Name:
Other Contact Number/eMail

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