Customer Issue Form
THIS FORM IS NOT ABLE TO BE USED FOR CANCELATIONS. PLEASE USE THE BOOK.
Select Location *
Select Customer Type *
Customer First & Last Name *
If this issue concerns a charge, please provide the first 5 & last 4 digits of the card that charged, separated by an 'X" "12345x4321". This will allow us to locate the transaction.
Customer Cell Phone *
Describe the date & time of issue event(s) if this refers to a single transaction (not an automatic recharge).
RFID Fast-Pass # (xxxxx+xxxxxx)
Vehicle Year/ Make/ Model *
Selected Action *
Explanation (why canceling, which plan to switch to, issue description) *
Has the customer visited before with the same issue?
Clear selection
Describe what the customer says happened during previous visits. What did the employee do?
Employee Name *
Submit
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