Comment Form

Access Scioto County is committed to providing you with safe and reliable transportation service and we want your feedback. Please use this form for suggestions, compliments, and complaints. You may also call us at 740-353-5626, visit our office at 601 Eighth Street, Portsmouth, Ohio, or contact us by email, or U.S. postal mail at the address below. Please make sure to provide us with your contact information in order to receive a response.
Please address all suggestions, compliments, and complaints to ASC Coordinator Barbara Setser, 601 Eighth Street, Portsmouth, Ohio, 740-353-5626, ext. 208, [email protected].
If you feel that your civil rights have been violated please click here to view our complaint policy.

Comment Form

SECTION I: TYPE OF COMMENT (Please Choose One)

* Indicates required field

Select One *

If Othe, please specify: *

ADA Related? *

Yes No

SECTION II: CONTACT INFORMATION

Salutation (Select One) *

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Accessible Format Required *

Large Print TDD/Relay Audio Recording Other

If Other, please specify: *

SECTION III: COMMENT DETAILS

Date of Occurrence: *

Time of Occurrence: *

Name of Employee(s) or Others Involved: *

Vehicle Number: *

Direction of Travel (Select One) *

Location of Incident: *

Mobility Aid Used (if any): *

If above information is unknown, please provide other descriptive information to help identify the employee: *

Description of Incident or Message: *

SECTION IV: FOLLOW UP

May we contact you if we need more details or information? *

Yes No

What is the best way to reach you? (Select One) *

If a phone call is preferred, what is the best day and time to reach you? *

SECTION V: DESIRED RESPONSE

Select One *

I agree to receiving marketing and promotional materials *

Submit