Complaint Form « Pacific Cabs

Name*

First

Last

Phone*

Secondary Phone

Best Time to Call*

:

AM/PM

Address*

Street Address

Address Line 2

City

Province

Postal Code

In What form do you want to receive the information?

Incident Information

Service Type*

Taxi Number*

Date of Incident*

Time of Day*

:

AM/PM

Location where the incident took place (nearest intersection) or location where you were picked up*

Dispatcher Service Performance

Driver/Taxi Service Performance

Unsafe driving

If any of the above does not describe your complaint or you wish to provide additional information please use the space provided below:

TO BE COMPLETED BY TAXI REPRESENTATIVE:

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Name

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