Transportation Needs Survey
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1
. What means of transportation do you currently use to get to your destination? (Check all that apply)
What means of transportation do you currently use to get to your destination? (Check all that apply)
walk
bicycle
have a car
use a cab company
ride with others whenever possible
have my own vehicle, but am unable to use it reliably (e.g., due to the cost of gasoline, physical state of the vehicle...)
2
. Think of the common trips you make during an average week. Please rank the following in terms of how often you travel to each destination. 1 = least common, 7 = most common
1
2
3
4
5
6
7
Work
*
Think of the common trips you make during an average week. Please rank the following in terms of how often you travel to each destination. 1 = least common, 7 = most common Work 1
Work 2
Work 3
Work 4
Work 5
Work 6
Work 7
Grocery Shopping
Grocery Shopping 1
Grocery Shopping 2
Grocery Shopping 3
Grocery Shopping 4
Grocery Shopping 5
Grocery Shopping 6
Grocery Shopping 7
School/College
School/College 1
School/College 2
School/College 3
School/College 4
School/College 5
School/College 6
School/College 7
Recreation/Socializing
Recreation/Socializing 1
Recreation/Socializing 2
Recreation/Socializing 3
Recreation/Socializing 4
Recreation/Socializing 5
Recreation/Socializing 6
Recreation/Socializing 7
Child Care
Child Care 1
Child Care 2
Child Care 3
Child Care 4
Child Care 5
Child Care 6
Child Care 7
Other shopping
Other shopping 1
Other shopping 2
Other shopping 3
Other shopping 4
Other shopping 5
Other shopping 6
Other shopping 7
Doctor/Dentist/Therapist/Medical Care
Doctor/Dentist/Therapist/Medical Care 1
Doctor/Dentist/Therapist/Medical Care 2
Doctor/Dentist/Therapist/Medical Care 3
Doctor/Dentist/Therapist/Medical Care 4
Doctor/Dentist/Therapist/Medical Care 5
Doctor/Dentist/Therapist/Medical Care 6
Doctor/Dentist/Therapist/Medical Care 7
Other (please specify)
3
. How many times per week do you make a trip to your most common destination?
How many times per week do you make a trip to your most common destination?
One time only
More than once a day
Less than once a day
1-6 times a week
Once a day
4
. Do you believe there is a community need for public transportation?
Do you believe there is a community need for public transportation?
Yes
No
5
. Does lack of transportation affect your daily activities?
Does lack of transportation affect your daily activities?
Yes
No
6
. Do you know somebody who is in constant need of public transportation?
Do you know somebody who is in constant need of public transportation?
Yes
No
7
. Which of the following has been affected due to lack of transportation? (Check all that apply.)
Which of the following has been affected due to lack of transportation? (Check all that apply.)
Not being able to get to work or school when needed
Becoming stranded away from home
Not being able to go somewhere else when needed
Being late for or missing an appointment/meeting
Other (please specify)
8
. During the past 6 months, how many times were you NOT able to get to a desired destination because of a lack of transportation?
During the past 6 months, how many times were you NOT able to get to a desired destination because of a lack of transportation?
Never
Once
About once a month
About once a week
More than once a month
9
. During which season do you have the most difficulty getting to your desired destination because of lack of transportation?
During which season do you have the most difficulty getting to your desired destination because of lack of transportation?
Spring
Summer
Fall
Winter
10
. Does more than one transit agency serve your neighborhood/community?
Does more than one transit agency serve your neighborhood/community?
Yes
No
11
. If yes, can you provide the agencies names and/or phone numbers?
If yes, can you provide the agencies names and/or phone numbers?
12
. Are you willing to pay for one-way public transportation?
Are you willing to pay for one-way public transportation?
Yes
No
13
. If yes, what range would you be able to pay?
If yes, what range would you be able to pay?
Up to $2.00
$2.00-$3.00
$3.00 or more
14
. If yes, what form of payment would you use?
If yes, what form of payment would you use?
Cash
Account with provider
Financial Assistance (e.g. Medicare…)
Other (please specify)
15
. On what days of the week are you most in need of transportation? (Check all that apply.)
On what days of the week are you most in need of transportation? (Check all that apply.)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
16
. During what hours of the day are you most in need of transportation? (Check all that apply.)
During what hours of the day are you most in need of transportation? (Check all that apply.)
6 am to 8 am
8 am to 10 am
10 am to noon
Noon to 2 pm
2 pm to 4 pm
4 pm to 6 pm
6 pm to 8 pm
8 pm to 10 pm
Between 10 pm and 6 am
17
. In what zip code do you live?
In what zip code do you live?
18
. In what county do you live?
In what county do you live?
Fairfield
Newberry
Lexington
Richland
Other (please specify)
19
. In what council district do you live? (You may also choose to name your council person)
In what council district do you live? (You may also choose to name your council person)
20
. In what city, town, or area do you live? (Winnsboro, Blair, Newberry, Eastover, etc...)
In what city, town, or area do you live? (Winnsboro, Blair, Newberry, Eastover, etc...)
21
. In what city, town, or area do you work? (Please include your zip code!)
In what city, town, or area do you work? (Please include your zip code!)
22
. In what county do you work?
In what county do you work?
Fairfield
Newberry
Lexington
Richland
Other (please specify)
23
. Do you require an escort when using public transit?
Do you require an escort when using public transit?
Yes
No
24
. What is your gender?
What is your gender?
Male
Female
25
. What is your employment status? (Check all that apply.)
What is your employment status? (Check all that apply.)
Unemployed
Retired
Disabled
Part-time
Full-time
Student
26
. What is your household’s total yearly income before taxes?
What is your household’s total yearly income before taxes?
Under $10,000
$10,000 to less than $20,000
$20,000 to less than $30,000
$30,000 to less than $40,000
$40,000 to less than $50,000
$50,000 and above
27
. Do you have additional transportation limitations?
Do you have additional transportation limitations?
Yes, disability
Yes, health concerns
Yes, another limitation:
No limitations
If yes, another limitation (please specify)
*
28
. Do you have any unmet needs that have not been identified in this survey?
Do you have any unmet needs that have not been identified in this survey?
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