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By submitting or requesting a quote for services, you acknowledge and agree that you are not requesting information as a competitor, potential competitor, or for benchmarking, comparison, or other competitive purposes. You further acknowledge that you are not using a fictitious name, false identity, or misleading information when requesting a quote or service information.

Long Distance Elder Relocation, LLC reserves all rights to pursue any available legal remedies against individuals or entities who submit deceptive, false, or misleading requests.

You also understand that submitting this form or requesting a quote does not establish you as a client or customer of Long Distance Elder Relocation, LLC (“LDER”). You will not become a client, and no service date or time is guaranteed, unless and until LDER accepts your trip, you pay the required deposit, and you agree to all required terms and conditions.

This form is used only to evaluate availability and screen a potential client’s transportation needs. It does not create, serve as, or represent a clinical or health record.

By clicking Submit, you confirm that you have read, understood, and agree to be bound by these terms.