SDOT Curb Ramp Survey (Alternate Version)

Please complete this survey to help SDOT help you.

Information about you.

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* 1. Do you live in Seattle?

Yes

Don't know

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* 2. Where in Seattle do you live?

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* 3. Do you have a disability?

Yes

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* 4. What is your disability?

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* 5. Do you use:

Walker, cane, or crutches

Wheelchair (manual)

Wheelchair (power)

Electric scooter

Other (please specify)

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* 6. Are you:

Blind

Deaf

Deaf Blind

Other (please specify)

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* 7. Do you use:

Service animal / guide dog

White cane

Other (please specify)

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* 8. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65 and over

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* 9. Are you:

African American/Black

Asian

Caucasian/White

Hispanic/Latino

Native Hawaiian/Pacific Islander

Native American/Native Alaskan

Other race or combination of (please specify)

Now for some curb ramp questions.

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* 10. Are curb ramps missing from your sidewalks?

	No	Sometimes	Yes
Curb ramps are missing	Curb ramps are missing No	Curb ramps are missing Sometimes	Curb ramps are missing Yes

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* 11. Are curb ramps broken on your sidewalks?

	No	Sometimes	Yes
Curb ramp condition	Curb ramp condition No	Curb ramp condition Sometimes	Curb ramp condition Yes

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* 12. What makes curb ramps hard to use?

Broken or cracked

Too steep

No warning surface for the blind

Objects on ramp

Angle of ramp

Water at bottom of ramp

Other (please specify)

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* 13. Does the angle of the ramp make it hard to use?

	Yes	Sometimes	No
Curb ramp angle	Curb ramp angle Yes	Curb ramp angle Sometimes	Curb ramp angle No

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* 14. What is most important to fix? (put in order)

Old, broken curb ramps

No curb ramp at sidewalk

No sidewalks or curb ramps

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* 15. Can you use curb ramps on steep streets?

	Yes	Sometimes	No
Use	Use Yes	Use Sometimes	Use No

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* 16. Which is most important to get to? (put in order)

Schools and libraries

Government buildings

Bus and train stations

Offices and shops

Medical buildings

Homes for elderly

Parks

Neighborhoods

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* 17. Where do you need to go where curb ramps are broken or missing?

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* 18. What is the most important to you? (put in order)

Fixing sidewalks

Building new sidewalks

Fixing crosswalks

Talking street crossing signals

Good routes around construction areas

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* 19. Did you know you can ask the city to build curb ramps where you need them?

Yes

Ask the city to build curb ramps by clicking this link:

SDOT ADA Request Page

If you have questions, contact Michael.Shaw@seattle.gov or call 206-615-1974.

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* 20. Would you like to go to meetings to talk about sidewalk improvements for people?

Yes

Don't know

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* 21. If you would like to go to meetings to discuss sidewalks, give us your name and phone number or email.

Name

Phone