Restaurant Delivery Partner Opt-Out Request Form
Submit this form to request removal or suspension from a specific restaurant or delivery program. Please complete all required fields to ensure prompt processing.
Full Name
*
First Name
Last Name
Partner ID or Employee Number
*
Email Address
*
example@example.com
Restaurant or Delivery Program
*
Opt-Out Scope
*
Permanent Removal
Temporary Suspension
Opt-Out from Specific Restaurant Only
Opt-Out from All Assignments
Requested Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Opt-Out
*
Personal Reasons
Health or Safety Concerns
Scheduling Conflicts
Unsatisfactory Working Conditions
Other (please specify)
Additional Supporting Details (optional)
Preferred Contact Method
*
Email
Phone Call
Text Message
Phone Number (if selected as preferred contact method)
Please enter a valid phone number.
Format: (000) 000-0000.
Submit Opt-Out Request
Should be Empty: