OKM Form

Transportation Booking Form
To schedule transportation, please complete and submit this booking form. Your assigned driver will reach out to schedule your pick-up within 24 hours.
PASSENGER INFORMATION
Number of Passengers
Contact Name
First NameLast Name
E-mail
Phone Number
Format: (000) 000-0000.
Is a car seat required?
Is special transportation services required for any disabled passenger?
If yes, please state assistance needed.
TRANSPORT INFORMATION
Transport Type
Pick-Up Date/Time
MonthDayYearHourMinutesAM/PM Option
Pick-Up Location
Please include City and Zip code
Destination Pick-Up Date/Time
MonthDayYear
DateHourMinutesAM/PM Option
Destination Location
Additional Message:
You must schedule 24 hours in advance of your appointment date and time.
If you have any questions or concerns, please call One Kingdom Ministries at (724) 480-1718.
Transportation services are made possible by the Mercer County Behavioral Health Commission, Inc.
Should be Empty:

Transportation Booking Form