Southeastern Railway - Assisted travel booking form

All the information you need for your journey in one place

Assisted travel is offered to passengers with disabilities. And you can arrange assistance using the form below. We can only accept online bookings for journeys made on Southeastern.

We do ask for 24 hours notice to arrange assistance for your journey. So if you want to travel sooner, or would like to discuss something in more detail, please contact us on 0800 783 4524.

Please complete all fields mark with a *.

Title: *
Forenames:
Surname: *
Postcode:	LOOK UP ADDRESS
Address:
Town/City:
County:
We may need to contact you to confirm this booking so please make sure you have given us your contact details.
Email address: *
Phone number: *
Preferred method of contact: *	Email Phone

Departure date: *
Departure time: *
Departure station: *
Transport to departure station:
If other, please provide details:
via: (optional)
changing at: (optional)


Arrival station: *
Transport from arrival station:
If other, please provide details:

Departure date:
Departure time:
Departure station:
Transport to departure station:
If other, please provide details:
via: (optional)
changing at: (optional)


Arrival station:
Transport from arrival station:
If other, please provide details:

At which points of the journey do you need assistance? *
	All points (change of train is required) Departure and arrivals Departure station only Arrival station only Other
If other, please provide details:
Type of assistance required: *
	Visually impaired Hearing impaired Elderly Mobility impaired - no ramp Mobility impaired - ramp needed Verbally impaired Permanent own wheelchair user Wheelchair companion Own wheelchair, transfer to seat Railway wheelchair, transfer to seat Scooter user - size confirmed * Other physical condition
If other, please provide details:
(Please select all the types of assistance you require) * Please call 0800 783 4524 to confirm the scooter size.

Please note any other requirements you might have:

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London & South Eastern Railway Limited is a company registered in England (No.04860660).
Registered office: 3rd Floor, 41-51 Grey Street, Newcastle upon Tyne, NE1 6EE.