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other special request form Busy Bee
north american non EU residents only
SECURED & ENCRYPTED
Send us a reservation request-inquiry and we will get back to you with a speedy, affordable quote! or answer (usually within 72 hours or
less)
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* Indicates required question
have you used our services before?
*
Your answer
your email address?
*
Your answer
Your first Name
*
Your answer
Your last Name
*
Your answer
your phone #/ cell phone preferrred for text communication .
*
Your answer
is this a cell phone
*
yes
no
check in date
MM
/
DD
/
YYYY
check out date
MM
/
DD
/
YYYY
please select desired equiptment
mobility scooter
manual push wheelchair
both
other ( please describe below in "special message to us" section
Clear selection
what is the name of town and or hotel -venue, etc you will be staying at ? or location you will be using services. *
Your answer
whats going on with the persons mobility?
Your answer
WEIGHT of person using mobility equipment *
Your answer
HEIGHT
Your answer
do u plan on transporting equipment in a vehicle ?
Your answer
if any Special Message to us, write below.
Your answer
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