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1. What is your county of residence?

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2. Age

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3. Gender

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4. Race

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5.  Do you live...

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6. How did you learn about this transportation service?

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7. On average, how many times a month do you use this transportation service?

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8. Do you have any other means of transportation?

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9. Do you use this transportation service mostly to get to: (Please check all that apply)

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10. How would you rate the friendliness and courtesy of the drivers?

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11. How satisfied are you with the vehicles in terms of comfort, cleaniness and your ability to get on and off?

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12. How often do you have to reschedule medical appointments because you cannot get a ride when you need it?

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13. Is your driver on time picking you up from your home?

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14. Is your driver on time picking you up to take you home?

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15. Are you aware that you can make a donation toward the ride if you wish?

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16. Overall, how would you rate this transportation service?

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17. Do you have any recommendations for improving this transportation service?

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18. Additional Comments

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