Accompanied Transport for Individuals Survey

Accompanied Transport for Individuals

Cheshire West and Chester LINk have commissioned a research project into the potential need for accompanied transport to health appointments in a range of settings e.g. GP surgeries, hospitals etc in the area. Accompanied transport basically means door to door transport with someone to assist at the health premises if needed and is aimed at people who are unable to use public transport and do not have access to their own transport for whatever reason.

The research is aimed at assessing the need for this type of transport for older people, people with physical disabilities, people with learning difficulties and disabilities, and families with children with disabilities.

Strategic Partnerships Consultancy have been commissioned to carry out this research and we would appreciate your time in filling out this questionnaire.The questionnaire should take about 10 minutes to complete and needs to be done in one sitting - when you have finished please press Exit Survey and your response will be sent through to a central collection point. If you would like a paper copy please either email or phone and I will send one out - contact details below.

Thank you for your time. If you wish to discuss any of the aspects of this work, or would like to provide further information please do not hesitate to contact me on 0788 151 0304, or via email on info@sp-consultants.co.uk

Regards

Cathy Boyd
Strategic Partnerships Consultancy Ltd
19 Station Road
Weaverham
CW8 3PY

	Drive own car	Family /Friend Car	Taxi	Walk	Cycle	Bus	Train	Community Transport	Ambulance	Other
GP Surgery	*How would you get to the following health services? GP Surgery Drive own car	GP Surgery Family /Friend Car	GP Surgery Taxi	GP Surgery Walk	GP Surgery Cycle	GP Surgery Bus	GP Surgery Train	GP Surgery Community Transport	GP Surgery Ambulance	GP Surgery Other
Out Patients	Out Patients Drive own car	Out Patients Family /Friend Car	Out Patients Taxi	Out Patients Walk	Out Patients Cycle	Out Patients Bus	Out Patients Train	Out Patients Community Transport	Out Patients Ambulance	Out Patients Other
Day Surgery	Day Surgery Drive own car	Day Surgery Family /Friend Car	Day Surgery Taxi	Day Surgery Walk	Day Surgery Cycle	Day Surgery Bus	Day Surgery Train	Day Surgery Community Transport	Day Surgery Ambulance	Day Surgery Other
Screening	Screening Drive own car	Screening Family /Friend Car	Screening Taxi	Screening Walk	Screening Cycle	Screening Bus	Screening Train	Screening Community Transport	Screening Ambulance	Screening Other
Clinic	Clinic Drive own car	Clinic Family /Friend Car	Clinic Taxi	Clinic Walk	Clinic Cycle	Clinic Bus	Clinic Train	Clinic Community Transport	Clinic Ambulance	Clinic Other
Treatment for longterm conditions	Treatment for longterm conditions Drive own car	Treatment for longterm conditions Family /Friend Car	Treatment for longterm conditions Taxi	Treatment for longterm conditions Walk	Treatment for longterm conditions Cycle	Treatment for longterm conditions Bus	Treatment for longterm conditions Train	Treatment for longterm conditions Community Transport	Treatment for longterm conditions Ambulance	Treatment for longterm conditions Other
Out of Area	Out of Area Drive own car	Out of Area Family /Friend Car	Out of Area Taxi	Out of Area Walk	Out of Area Cycle	Out of Area Bus	Out of Area Train	Out of Area Community Transport	Out of Area Ambulance	Out of Area Other
Dental	Dental Drive own car	Dental Family /Friend Car	Dental Taxi	Dental Walk	Dental Cycle	Dental Bus	Dental Train	Dental Community Transport	Dental Ambulance	Dental Other
Emergency	Emergency Drive own car	Emergency Family /Friend Car	Emergency Taxi	Emergency Walk	Emergency Cycle	Emergency Bus	Emergency Train	Emergency Community Transport	Emergency Ambulance	Emergency Other

Accompanied Transport for Individuals

1. I am replying to this questionnaire:

2. Postcode Area

3. Age Group?

4. Do you consider yourself to be disabled?

5. Are you registered disabled?

6. What are your major barriers to accessing healthcare services?
Please choose top 3.

7. Have you ever used community transport? (This includes community car schemes with volunteer drivers and Dial A Ride services)

8. How would you get to the following health services?

Accompanied Transport for Individuals

1. I am replying to this questionnaire:

2. Postcode Area

3. Age Group?

4. Do you consider yourself to be disabled?

5. Are you registered disabled?

6. What are your major barriers to accessing healthcare services? Please choose top 3.

7. Have you ever used community transport? (This includes community car schemes with volunteer drivers and Dial A Ride services)

8. How would you get to the following health services?

6. What are your major barriers to accessing healthcare services?
Please choose top 3.