Senior/Disabled/Rural Transportation Service Customer Survey

Our records indicate you used our Senior/Disabled/Rural Transportation Service. Please take a few minutes to tell us about the service you receive by completing this short survey and returning it to us in the enclosed envelope. If you would prefer to take this survey on-line, please visit Thank you for giving us the opportunity to serve you.

Area 7 Agency on Aging & Disabled Services
West Central Indiana Economic Development District
1718 Wabash Ave, Terre Haute, IN 47807
(812) 232-2675 or (800) 489-1561

* 1. Do you find it easy to schedule transportation appointments?

* 2. Do you find the individual making your appointment(s) to be pleasant and helpful?

* 3. Does the van usually arrive on time to pick you up for your appointments?

* 4. Overall, is your driver polite and courteous?

* 5. Is you driver helpful in assisting you off and on the van?

* 6. Is the van usually clean and in good working condition?

* 7. Are you returned from your trip(s) in a prompt and courteous manner?

* 8. Overall, how would you rate our transportation service?

* 9. Additional Comments: (Please use back page if you need additional space.)

* 10. Contact Information & Date: (OPTIONAL)