Missoula Aging Services (MAS) is looking to identify community transportation needs so that we can work towards providing or improving services. We appreciate any information that you can provide. Your information will remain confidential. 

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* 1. What age range are you?

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* 2. Please describe your current state of health:

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* 3. What is your household composition?

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* 4. Please check your annual household income range:

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* 5. What is your current housing situation?

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* 6. Are you a veteran?

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* 7. What is the zip code of your current residence?

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* 8. What is your race/ethnicity?

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* 9. What is your most consistent mode of transportation?

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* 10. If you don’t drive a car, why not?

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* 11. If you don’t drive, how reliable are the people or organizations that provide rides?

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* 12. What prevents you from traveling outside your home? Check all that apply

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* 13. What is your confidence level when traveling? (This could be driving, riding with someone else, and/or using public transportation)

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* 14. What transportation programs are you aware of? Check all that apply

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* 15. Have you tried to use Mountain Line services? (Bus, Paratransit, Shuttle Van)

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* 16. Is your home in the service area for Mountain Line?

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* 17. What prevents you from using public transportation? (Bus, Paratransit, Shuttle Van) Check all that apply

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* 18. In an average week, how many vehicle trips do you take?

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* 19. If you had additional transportation options, how many more trips would you take per week?

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* 20. If you had better access to transportation would your quality of life:

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* 21. What times would you need to use a transportation service the most?

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* 22. What days of the week would you be most likely to travel using a transportation service?

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* 23. Do you need any of the following kinds of assistance when you travel? Check all that apply

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* 24. What type of service would be most helpful?

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* 25. How much would you be willing/able to pay a transportation service?

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* 26. What would you use a transportation service for? Check all that apply

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* 27. If your transportation needs are met, would you be interested in volunteering to assist others with transportation?

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* 28. Would you like to be entered into a drawing for a $25 Visa gift card?  Please provide your name and contact information:

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* 29. If you have any questions, would like to discuss your transportation needs or are interested in volunteering, please provide your name and phone number here and MAS staff will follow-up with you:

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