Please fill out the form below to book our welfare-taxi. ＊:required item Reservation Details Date of Service ＊ Preferred Time ＊ Pickup Location ＊ Destination Your Information Name ＊ Phonetic spelling (Please enter the phonetic spelling of your name) Email Address＊ (A confirmation e-mail will be sent automatically to your e-mail address.) Email Address (for confirmation)＊ Phone (Cellular phone) ＊ Please enter a contact number where we can reach you. Example)090-1234-5678 Your condition number of people＊ Size and number of luggage Do you have fever or sore throat？ YesNo If you have a fever, please fill in your temperature.（Example 37.5) Any special support needed About Your Personal Information＊ Please see our Privacy Policy. I agree to the Privacy Policy. Please note before booking:＊ • If the person is unconscious or unable to move, please call 911 (an ambulance) immediately. • Due to traffic or scheduling, your booking time may shift slightly. • Depending on availability, we may contact you to adjust your requested time. • Submitting the booking form does not guarantee a reservation. We’ll confirm your appointment after final scheduling. I have read and understood the above notes.
