Service Feedback & Complaint Form

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Service Feedback & Complaint Form

Transport U is committed to providing safe, respectful, and reliable transportation. Please use this form to share a concern, complaint, or feedback about a trip, driver, vehicle, or customer service experience.

Address: 7811 Montrose Rd Suite 540 Potomac, MD 20854
Telephone: Appointment/Dispatcher Line: (240) 475-7568
Telephone: Main Office: (301) 525-2000
Email: Fax: 240-715-9106
Email: Email: info@transportu.com

A. Complainant Information

Name (First and Last) *

Phone Number *

Email Address *

Preferred Contact Method *

Phone

No response needed

Are you completing this form for yourself or someone else? *

Myself

On behalf of a rider

Facility staff/case manager

Other

Rider’s Name (if different from above)

B. Trip Information

Date of Trip *

Approximate Pick-Up Time

Pick-Up Location

Drop-Off Location

Type of Trip

Ambulatory (walk-on)

Wheelchair

Stretcher

Other / Not sure

Driver’s Name or Vehicle Number (if known)

C. Nature of Complaint / Feedback

What is this regarding? (Check all that apply) *

Driver behavior or professionalism

Timeliness (late pick-up or drop-off)

Vehicle condition or safety

Scheduling or communication

Billing/authorization

Accessibility or accommodations

Other

Please describe what happened. *

Have you reported this issue to anyone at Transport U before?

Yes

D. Desired Outcome

How would you like this issue to be resolved?

Do you want Transport U to contact you with the outcome of our review? *

Yes, please contact me

No, I do not need a response

E. Consent & Acknowledgment

Consent Statement *

I understand that the information I am submitting will be used by Transport U to review and respond to my complaint or feedback. I certify that the information provided is true and accurate to the best of my knowledge.