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Transportation Survey
1.
How do you usually get to your medical appointments?
Private Vehicle
Medicaid Transportation
Friend/Family
Walk/Bike
2.
Have you ever missed an appointment due to a lack of transportation?
Yes
No
3.
If we provided transportation for you to come to your appointments at Bland County Medical Clinic, Orchard Creek Clinic, or Bland County Dental Office, would you use it?
Yes
No
4.
Do you feel like your health is affected by missing your doctor’s appointments?
Yes
No
5.
Do you have any of the following chronic conditions?
Diabetes
Hypertension
Heart Disease
Thyroid Disease
6.
Do you require medical equipment such as a wheelchair/scooter, or walker to move around?
Yes
No