The Five County Association of Governments in collaboration with the Utah Department of Transportation are conducting an assessment of transportation needs in Beaver, Garfield, Iron, Kane and Washington Counties. Please complete this survey to tell us what you think! We will not ask for your name or address and individual survey responses will not be made public. For more information please contact RLS & Associates at (937) 299-5007 and ask to speak with Christy.

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* 1. What county do you live in?

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* 2. What city or town do you live in?

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* 3. What forms of transportation do you use regularly?

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* 4. Do you have difficulty getting the transportation you need to any of the following types of destinations?

  No difficulty Sometimes difficult Frequently difficult Always difficult Not applicable to me
Workplace
Medical or Dental Care
Shopping/Pharmacy
Education
Human service agencies or government offices
Recreational or social outings
Other trip purposes

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* 5. What days of the week do you most often need transportation but do not have a ride? (Please select all that apply.)

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* 6. During what hours of the day do you most often need transportation but do not have a ride? (Please select all that apply.)

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* 7. Where do you most commonly need to travel for the following purposes?

  Most Frequent Location Other Location Other Location
Employment
Medical/Dental Care
Shopping/Pharmacy
Education
Human service agencies or government offices
Recreational or social outings
Other trip purpose(s)

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* 8. What is your age group?

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* 9. Do you or a member of your household have a disability that requires you to use a cane, walker, wheelchair, and/or another device to help you get around?

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* 10. How many vehicles (cars/trucks) are in your household?

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* 11. What is your household's annual income level?

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* 12. Please share any input you may have about transportation needs in your community.

 
 100% of survey complete.

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