UTS

Personal Information

First Name *

Middle Name (Optional)

Last Name *

Phone Number *

Email Address *

Date of Birth *

Who is this ride for?

This ride is for me This ride is for someone else

Who will be paying for the service?

I will be paying Someone else will be paying

Pickup and Drop-Off Information

Pickup - Street Address *

Pickup - City *

Pickup - State *

Pickup - Zip Code *

Drop-Off - Street Address *

Drop-Off - City *

Drop-Off - State *

Drop-Off - Zip Code *

Service Details

Service Type *

Add Special Instructions

When would you like your ride? *

For Today *

Select Time *

Trip Type *

Would you like the driver to wait? *

Number of Passengers *

Notification Preference *

Miles You Are Traveling *

Extra Stops

Policy Agreement

Refund Policy: No refunds are provided for services unless United Taxi Services cannot provide the service. All payments must be made by card, and invoices will be sent via text or email.

Full Name *

Date of Agreement *

Summary of Information

Your entered details will appear here...

Financial Summary

Booking fee and miles will display here based on input.

UTS Delivery

UTS DELIVERY

Personal Information

Customer Full Name * Phone Number * Email Address *

Service Selection

Select Service Needed: Have your services been paid for? Yes No

Amount to Cover Charges:

Select Birth Date (MM/DD/YYYY):

Select Food Place:

Please Specify:

Number of Items: What You Ordered:

Special Instructions:

Estimated Miles:

Appointment Details

Select Appointment Date: Select Appointment Time:

Payment Information

Who Will Be Paying?

Payee First Name: Payee Last Name: Payee Email: Payee Full Home Address: Payee Phone Number:

Who Is the Delivery For?

Recipient First Name: Recipient Last Name: Recipient Email: Recipient Full Home Address: Recipient Phone Number:

How Would You Like to Be Notified?

Pickup Address

Full Address: Apartment Number: Floor Number:

Drop-off Address

Full Address: Apartment Number: Floor Number:

Extra Deliveries

Summary

Finance Summary

UTS Delivery

UTS DELIVERY

Personal Information

Customer Full Name * Phone Number * Email Address *

Service Selection

Select Service Needed: Have your services been paid for? Yes No

Amount to Cover Charges:

Select Birth Date (MM/DD/YYYY):

Select Food Place:

Please Specify:

Number of Items: What You Ordered:

Special Instructions:

Estimated Miles:

Appointment Details

Select Appointment Date: Select Appointment Time:

Payment Information

Who Will Be Paying?

Payee First Name: Payee Last Name: Payee Email: Payee Full Home Address: Payee Phone Number:

Who Is the Delivery For?

Recipient First Name: Recipient Last Name: Recipient Email: Recipient Full Home Address: Recipient Phone Number:

UTS

Personal Information

Who is this ride for?

Who will be paying for the service?

Pickup and Drop-Off Information

Service Details

Extra Stops

Policy Agreement

Summary of Information

Financial Summary

Price Acceptance

UTS DELIVERY

Personal Information

Service Selection

Appointment Details

Payment Information

Who Is the Delivery For?

Pickup Address

Drop-off Address

Extra Deliveries

Summary

Finance Summary

UTS DELIVERY

Personal Information

Service Selection

Appointment Details

Payment Information

Who Is the Delivery For?

Pickup Address

Drop-off Address

Extra Deliveries

Summary

Finance Summary

SERVICES WE PROVIDE

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