Arka transportation
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If you need a ride for your doctor appointment please fill out this form and we will get back to you as soon as possible.
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Comment
*
Please write your Doctors name , address and date for the doctor appointment.
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If you had ride with our transportation please take a short survey about the experience you had with
Arka Transportation
. Thank You
Survey
How did you hear about our company?
*
Internet Search
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Friend
Other
If Other please specify:
*
What is your age?
*
Less than 13
13-18
19-25
26-35
36-50
Over 50
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Which city do you live?
*
Los Angeles
San Fernando Valley
San Bernardino Valley
Antelope Valley
Glendale
Burbank
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Please tell us a few words about your experience with Arka Transportation.
*
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