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* 1. Please enter your full name:

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* 2. Please enter your address:

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* 3. What is your age?

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* 4. What type of mobility aid do you use?

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* 5. Please specify the reason for hiring transport and number of people on the excursion?

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* 6. What service provider do you used?

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* 7. How much notice do you typically give the service provider before an excursion?

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* 8. Please indicate the cost involved and your preferred method of payment.

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* 9. How likely is it that you would recommend this service to a friend or colleague?

Not at all likely
Extremely likely

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* 10. Do you have any additional comments or suggestions

T