Transportation Survey - RidersTransportation Survey

1. I need transportation because: (Check all that apply.)

I need transportation because: (Check all that apply.) I am an older adult and I don't drive I am disabled I am homeless I am too ill to drive	I do not have a car I do not have a driver's license I do not have auto insurance I am not old enough to drive
Other (please specify)

2. Do you know what transportation choices are available for you?:

Do you know what transportation choices are available for you?: Yes	No
Other (please specify)

3. I need transportation to: (Check your top three destinations.)

I need transportation to: (Check your top three destinations.) Banking Child care Community events Court appointments Dental Dialysis Drug/alcohol treatment Family or friends	Food bank Grocery shopping Job training Meal sites Medical appointments Mental Health treatment Pharmacy Physical therapy	Recreational facilities School Social service appointments Vocational rehabilitation Work WorkSource appointments
Other (please specify)

4. I need to go to: (Check your top three locations.)

I need to go to: (Check your top three locations.) Bonney Lake Buckley Burnett Carbonado Eatonville Gig Harbor Kapowsin Key Peninsula - North Key Peninsula - South	Lakewood McKenna Parkland Puyallup Olympia Orting Roy Seattle Spanaway	South Prairie Sumner Tacoma - Downtown/Tacoma Dome Tacoma - Eastside Tacoma - North Tacoma - Northeast Tacoma - South Tacoma - West Wilkeson
Other (please specify)

5. I use the following means of transportation.

I use the following means of transportation. My own vehicle Family or friends Pierce Transit bus Pierce Transit SHUTTLE Taxi	Volunteer driver (Catholic Community or Lutheran Social Services) Medicaid (Paratransit Services) Road to Independence Beyond the Borders
Other (please specify)

6. Do you use a mobility aid when you travel?

Do you use a mobility aid when you travel? I can travel unassisted I use a wheel chair I use a scooter.	I use a walker. I use a stretcher. I travel with a service animal.
Other

7. Below are features of transportation services. Please rate how important each feature is to you, using a number from 1-5, with 1 being not at all important and 5 being very important.

	Not at all important				Very important
Service within your local community	*Below are features of transportation services. Please rate how important each feature is to you, using a number from 1-5, with 1 being not at all important and 5 being very important. Service within your local community Not at all important	Service within your local community	Service within your local community	Service within your local community	Service within your local community Very important
Service beyond your local community	Service beyond your local community Not at all important	Service beyond your local community	Service beyond your local community	Service beyond your local community	Service beyond your local community Very important
Service to out of county locations	Service to out of county locations Not at all important	Service to out of county locations	Service to out of county locations	Service to out of county locations	Service to out of county locations Very important
Service to regional medical facilities	Service to regional medical facilities Not at all important	Service to regional medical facilities	Service to regional medical facilities	Service to regional medical facilities	Service to regional medical facilities Very important
Daytime Service	Daytime Service Not at all important	Daytime Service	Daytime Service	Daytime Service	Daytime Service Very important
Evening Service	Evening Service Not at all important	Evening Service	Evening Service	Evening Service	Evening Service Very important
Weekend Service	Weekend Service Not at all important	Weekend Service	Weekend Service	Weekend Service	Weekend Service Very important
Help with doors or packages	Help with doors or packages Not at all important	Help with doors or packages	Help with doors or packages	Help with doors or packages	Help with doors or packages Very important
Help getting to vehicle or getting in and out of vehicle	Help getting to vehicle or getting in and out of vehicle Not at all important	Help getting to vehicle or getting in and out of vehicle	Help getting to vehicle or getting in and out of vehicle	Help getting to vehicle or getting in and out of vehicle	Help getting to vehicle or getting in and out of vehicle Very important
Wheelchair accessible vehicle	Wheelchair accessible vehicle Not at all important	Wheelchair accessible vehicle	Wheelchair accessible vehicle	Wheelchair accessible vehicle	Wheelchair accessible vehicle Very important

8. For mapping purposes, please provide your pickup location (cross streets and city)

For mapping purposes, please provide your pickup location (cross streets and city)

9. Please provide the address for your top 3 destinations. (Address or cross streets and city)

Please provide the address for your top 3 destinations. (Address or cross streets and city) 1.
2.
3.

10. If you would like us to contact you about transportation resources please tell us how to contact you.

If you would like us to contact you about transportation resources please tell us how to contact you.

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Transportation Survey - Riders
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