Yavapai County Transportation Assessment Question Title * 1. Which of the following age groups do you belong to? 18 or younger 19-35 years of age 36-59 years of age 60 years or older Question Title * 2. What is your gender? Female Male Question Title * 3. What zip code do you currently live in? Question Title * 4. What is your approximate average household income? $0-$24,999 $25,000-$49,999 $50,000 or higher Question Title * 5. Do you currently have a driver's license? Yes No Question Title * 6. Which of the following is your main source of transportation? Personal Vehicle Shuttle Service Bicycle/Motorized Bike Taxi/Cab Bus Walking Other (please specify) Question Title * 7. Do you or anyone in your household have a disability or chronic illness? Yes No Question Title * 8. In the last 12 months, have you missed a medical appointment, job interview or work because of lack of transportation? Yes No Question Title * 9. If available, how often would you use public bus transportation? Daily Weekly Monthly Several times a year Never Question Title * 10. Which would you most likely use public transportation for? (Check all that apply) Health Care (Medical, dental, vision, etc.) Food (Groceries or dining out) Entertainment/Recreation School Everyday Use Other (please specify) Done