Title
∗
--Select--
Miss
Mr
Mrs
Ms
Dr.
Lady
Lord
Mx.
Prof.
Reverend
Master
Mr + Mrs
Capt
Sister
Major
Dame
Sir
Title is required
Preferred method of contact
∗
--Select--
Email
Phone
Text
Preferred method of contact is required
Are you travelling with a companion?
No
Yes
Required assistance
GWR train services can carry manual or powered wheelchairs up to the following dimensional and weight limitations: Width 700mm, Length (including footplates) 1200mm, Weight (including passenger) 300kg.
Which point of the journey do you require assistance?
∗
--Select--
All points (including changing trains)
Destination Station Only
Origin and Destination Station
Origin Station Only
Other
Which point of the journey do you require assistance? is required
Are you travelling with an assistance dog?
No
Yes
If other please give details
We are unable to submit your form with some of the special characters you’ve used entered
If other, specify details
We are unable to submit your form with some of the special characters you’ve used entered
Mobility
--Select--
Wheelchair user(manual) (within max dimensions)
Wheelchair user(powered) (within max dimensions)
Scooter user (within max dimensions)
Other mobility aid user
Other mobility impairment
If you selected "other" please specify details
We are unable to submit your form with some of the special characters you’ve used entered
Outward journey
Please tell us about how you will be arriving at the station. In order to help us provide you with the correct assistance, please arrive at your departure station 30 minutes before your train leaves and contact a member of staff.
How are you arriving at your origin station?
--Select--
Bus
Car
Train/Metro/Tube
Taxi
Pedestrian/Other
If you selected "other" please specify details
We are unable to submit your form with some of the special characters you’ve used entered
How are you departing from your destination station?
--Select--
Bus
Car
Train/Metro/Tube
Taxi
Pedestrian/Other
If you selected "other" please specify details
We are unable to submit your form with some of the special characters you’ve used entered
Are you returning?
No
Yes
Return journey
Please tell us about how you will be departing the station.
How are you arriving at your origin station?
--Select--
Bus
Car
Train/Metro/Tube
Taxi
Pedestrian/Other
If you selected "other" please specify details
We are unable to submit your form with some of the special characters you’ve used entered
How are you departing from your destination station?
--Select--
Bus
Car
Train/Metro/Tube
Taxi
Pedestrian/Other
If you selected "other" please specify details
We are continuously making improvements to Passenger Assist. We would like to share Passenger Assist data with GWR’s research supplier, other train operating companies, and the rail regulator and their research suppliers to conduct research to drive customer journey improvements – do you agree to be contacted regarding your experience?
∗
--Select--
No
Yes
We are continuously making improvements to Passenger Assist. We would like to share Passenger Assist data with GWR’s research supplier, other train operating companies, and the rail regulator and their research suppliers to conduct research to drive customer journey improvements – do you agree to be contacted regarding your experience? is required