Region 6 Transportation Needs Survey - Consumer Survey Question Title * 1. Where do you live? Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 2. What best describes your age? Under 18 19-35 36-65 Over 65 Question Title * 3. Do you use public transportation? Yes No Question Title * 4. If you answered yes, how frequently do you use public transportation? Daily Once a week More than once a week Once a month A few times a year Question Title * 5. If you answered no, why don't you use public transportation? (Check all that apply.) I have other reliable transportation. I don not know how to use it. I do not know where and when it goes. I have not considered it as an option. I did not know it was available to me. It costs too much. It is confusing. It is inconvenient. It does not run when I need/want it to run. It does not go where I need/want it to go. There are language barriers/a lack of translation services. The bus stop is too far. There is no public transit available where I live. I do not qualify for transportation services assistance. I have no money for public transportation. Other (please specify) Question Title * 6. If you do use public transportation, what do you use public transportation for? (Check all that apply.) Work. Medical appointments. Shopping. School. Visiting friends or family. Religious activities. I do not use public transportation. Other (please specify) Question Title * 7. If you use public transportation for medical appointments, are any outside of the county? Yes No Question Title * 8. If you use public transportation for medical appointments outside the county, where are the appointments located? Question Title * 9. When do you and/or your household need public transportation? (Check all that apply.) Weekday mornings 6:00 am to 12:00 pm. Weekday afternoons 12:00 pm to 5:00 pm. Weekday evenings 5:00 pm to 10:00 pm. Weekends 7:00 am to 5:00 pm. Weekends 5:00 pm to 10:00 pm. Weekends after 10:00 pm. Other (please specify) Question Title * 10. What do you think would help to improve public transportation services in your region? Question Title * 11. What are some common transit issues/barriers found in your region (for example, need for extended hours of service, affordability, connections between needed destinations.) Question Title * 12. Are there any places that you would like to go but cannot due to a lack of transportation? Yes No Question Title * 13. If yes, where? Question Title * 14. Would you like us to contact you for follow-up information regarding your survey answers? Yes No Done