Reaction form on services and complaints

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desired connection time

0' 10' 20' 30'

how do you want to start the trip?

by foot by bike by car all

how do you want to end the trip?

by foot by bike by car all

means of transport for your trip

train

bus

metro

tram

Include slower trains

No Yes

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Civilité (*)

Mister

Mrs

Nom (*)

Prénom (*)

Adresse e-mail (*)

Date de naissance

Rue (*)

Numéro (*)

Boite

Code Postal (*)

Commune (*)

Pays (*)

N° de GSM

N° de téléphone

Je suis déjà client (*)

Date des faits

Gare de départ

Heure de départ

Minute de départ

Numéro de train

Gare de correspondance

Gare de destination

Objet de la demande (*)

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