REQUEST SERVICE

REQUEST FOR TRANSPORTATION SERVICE

Complete the form below and well contact your to confirm your reservation. All requests are subject to approval and verification.

Name of Client*
First Last
What type of service are you requesting?
Pickup Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Drop-off Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Contact Name*
First Last
Contact Phone*
Contact Email
Date of Transportation*
Appointment Time*

: HH

MM
Pickup Time*

: HH

MM
Anything else that you want us to know.

CORPORATE OFFICE

3049 Cleveland Avenue, Suite 275
Fort Myers, FL 33901
239.479.1444
dispatch@medicabtrans.com
Mon – Sat . 7:00 a.m. – 6:00 p.m.

OUR SERVICES

PATIENT TRANSPORT

LOCAL TRANSIT

NO QUESTIONS ASKED GUARANTEE

Because you choose to let us serve you Thank you. “We Pledge to keep our promises by offering you 100% No Questions Asked Guarantee for all we do to serve you. If we fail at any level of your expectation you’re Guaranteed a 100% refund of your money back, no questions asked. We want you to say that our service compared to no other was extraordinary. If you don’t enjoy results this good even better call Dispatch immediately, you have a right to ask for a full refund guaranteed no questions asked. We don’t deserve to keep your money if you feel cheated; you have a right to a full refund immediately. Call say we failed you and you want a refund. We promise 100% money back guaranteed no questions asked and NO hard feelings whatsoever on our part.”

We guarantee to pick you and or your loved one at the agreed time, we guarantee the best experience for you and your loved one, we guaranteed and promise a clean, safe, timely ride on time all the time 100% guaranteed.