Objednávka prepravy osôb na vozíku alebo pomoci s prepravou EN

BOOKING FORM
FOR WHEELCHAIR PASSENGERS OR PASSENGERS REQUIRING ASSISTANCE.

We kindly remind You to submit Your order at least 24 hours prior to the journey.


INFORMATION ABOUT THE SERVICES PROVIDED

* Required data








1. TRANSPORTATION DETAILS

ONWARD JOURNEY

Journey date:*

Initial station:*

Final destination:*

Train connection:
(train number or the departure/arrival times, in case of more connecting trains – please list all train connections)

RETURN JOURNEY

Journey date:

Initial station:*

Final destination:*

Train connection:
(train number or the departure/arrival times, in case of more connecting trains – please list all train connections)

2. PASSENGER DETAILS

Name(s) and Surname:*

Address:*

PRM card number:
(if PRM-card holder)

Your contact telephone number:*

E-mail:*

Other way to contact you:

3. SUBMITTER DETAILS

Name(s) and Surname:

Telephone, e-mail or other contact to be used to inform you about the status of your booking (acceptance/denial):

4. WHEELCHAIR TYPE/SPECIAL NEED

Please, specify:*

Mechanical wheelchairElectrical/voltaic wheelchairRollatorTricycleOther (please, specify in the note below)

Notes:

5. ACCOMPANIMENT

Please, specify:*

with a guidewithout a guidewith a guiding dogother (please, specify within the notes below)

Notes:

6. REQUIRED ASSISTANCE

Please, specify:*

Coupling of a carriage with lifting platform – wheelchair embarkationAssistance with boarding/disembarkation using the mobile lifting platform of infrastructure manager ŽSRAssistance for boarding/disembarkationAssistance offering the barrier-free access to the trainReservation of a couchette (when travelling by the night train R 614/R17614/R 615 Zemplín on the route Bratislava – Košice – Humenné and back)Other (please, specify within the notes below)

Notes:


Your order was sent to the Contact Centre of Železničná spoločnosť Slovensko. In case you do not receive any reply within 24 hours, please call +421 24 48 58 188 or send e-mail to info@slovakrail.sk. Thank you.


INFORMATION ON PERSONAL DATA PROTECTION