Transit Option Checkup

Exit this survey 

1. Please provide our Mobility Information Specialist the following information so he/she can determine what services are best suited to meet your needs:

Once received a representative will review and contact you to discuss possible options.

2. Are you 60 years of age or older?

3. Do you have a disability?

4. If you are disabled does your disability prohibit you from using public transportation?

5. Are you receiving TANF (Temporary Assistance for Needing Families) Cash or are you part of a low-income family with dependent children?

6. Please check the purpose of your transportation needs? (Check all that apply)

7. Please provide the starting address of your trip?

8. Please provide destination address?

9. What days per week would you require this ride? (Check all that apply)

10. Please provide us with the time(s) you would need this trip and any other pertinent information?