Reservation Form Fields marked with * are required How can we help you? *Book a rideQuote onlyHow did you hear about us? *Returning clientFacility recommendationYelpGoogleOtherTrip type *One-wayRoundLevel of service *Ambulatory transportation (sedan vehicle)Wheelchair-accessible transportationGurney (stretcher)Passenger's approximate height and weight? *Wheelchair renter needed?YesNoAppointment Date *Number of passengers? *Are You Booking For Yourself ? *YesNoBest Point of Contact *SchedulerPassengerScheduler's name *Scheduler's Phone *Scheduler's Email *PrefixMr.Mrs.Ms.Mx.MissDr.Prof.Passenger's first name *Passenger's last name *Passenger's email *Passenger's phone *Requested Pick Up Time *Hours-120102030405060708091011Minutes-00153045AMPMcharge accrue after 15 minutesAppointment Start TimeHours-120102030405060708091011Minutes-00153045AMPMIntended arrival timeEstimated Return Time *Hours120102030405060708091011Minutes00153045AMPMThis is the time you believe you'll be ready to go home (If you don't know, we encourage you to ask the facility when they expect you to be ready to home.)Starting Address *Apartment, suite, etcZIP / Postal Code *Destination Address *Apartment, suite, etcZIP / Postal Code *UPDATED 2022 PRICING- Please visit the pricing page before proceeding with your submission. * I understand the rates and accept the terms and conditionsSMS AUTHORIZATIONBy providing your phone number, you agree to receive text messages from Happy2Help Transportation. Message and data rates may apply. Message frequency varies.Additional notes0 / 180Submit
