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2. Contact Us

   If you have any questions or need assistance in completing this form, please contact us at (251)388-0086 or email ddixon@thewavetransit.com.

4. 1. Complaint Information (Optional Unless Follow-Up is Requested)

6. Name
8. Phone number
10. Email address
12. Preferred contact method

    1. Phone
    2. Email

    1. None

16. 2. Date & Time of Incident

18. Date
    Date
20. Time (if known)
    Time (if known)

24. 3. Location of Incident

26. Route

    1. Route 1 - Airport
    2. Route 4 - Springhill
    3. Route 5 - Highway 45
    4. Route 7 - Dauphin Street
    5. Route 9 - Broad Street
    6. Route 10 - Crosstown

    1. Route 11 - Dauphin Island Parkway
    2. Route 12 - Highway 90
    3. Route 14 - moda! Downtown Circulator
    4. Route 15 - Touminville
    5. Route 16 - Plateau
    6. Route 18 - Cottage Hill
28. Bus number (if known)
30. Bus stop / address / area

32. 4. Description of Incident

34. Description of incident

38. 5. Type of Complaint

40. Type of complaint (check all that apply)

    1. Driver did not deploy ramp of lift
    2. Driver did not allow service animal
    3. Lack of space for wheelchair/scooter
    4. Inaccessible bus stop or shelter

    1. Inadequate audio/visual announcements
    2. Discriminatory behavior
    3. Other (describe complaint below)
42. Other (describe complaint below)
44. Was a bus employee informed at the time?

    1. Yes
    2. No

    1. Not Sure
46. If yes, who?
48. Would you like a follow up?

    1. Yes
    2. No
50. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
52. Electronic Signature
54. Date
    Date
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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