Ross County COVID-19 Vaccine Transportation Options

Vaccination Transportation

Please complete by February 22, 2021. This survey is being sent to all public and private transportation providers in Ross County to establish an updated list of available transportation options for community members and organizations looking for transportation options to vaccination sites. This information is being requested by the Ohio Department of Transportation and will also be used in the 2021 update of the Ross County Coordinated Plan.

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* 1. Transportation Provider Name

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* 2. Primary Contact

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* 3. Phone Number

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* 4. Primary Contact Email Address

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* 5. Current Days of Operation

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

This question was entered incorrectly and cannot be changed. Please list your current days of operation here.

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* 6. Monday - Friday Hours of Operation (N/A if none)

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* 7. Saturday Hours of Operation (N/A if none)

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* 8. Sunday Hours of Operation (N/A if none)

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* 9. Do you provide transportation for the general public, client only, or a specific population?

General Public

Clients Only

Older adults only

Individuals with Disabilities only

Other (please specify)

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* 10. Current fare cost

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* 11. Do you offer a discount for older adults?

Yes

Other (please specify)

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* 12. Do you offer a discount for individuals with disabilities?

Yes

Other (please specify)

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* 13. Do you offer discounts to anyone traveling to a vaccination site?

Yes

Other (please specify)

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* 14. Do you provide assistance to individuals that require assistance in walking or entering/exiting a vehicle?

Yes

Other (please specify)

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* 15. Are personal care attendants permitted to accompany riders free of charge?

Yes

Other (please specify)

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* 16. Do you currently operate wheelchair accessible vehicles?

Yes

Other (please specify)

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* 17. How many wheelchair accessible vehicles are currently in your fleet?

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* 18. Do you currently operate stretcher/cot transport vehicles?

Yes

Other (please specify)

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* 19. Do you provide Medicaid covered transportation?

Yes

Other (please specify)

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* 20. Do you accept private healthcare insurance?

Yes

Other (please specify)

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* 21. Which of the following areas are included in your current service area

Anywhere in Ross County (You do not need to mark any other boxes)

Ross County and surrounding counties (You do not need to mark any other boxes)

Adelphi/Hallsville

Anderson/Slate Mills

Andersonville/Yellow Bud

Bainbridge

Chillicothe City Limits

Clarksburg

Frankfort/Roxabell

Huntington Twp.

Kingston

Kinnikinnick

Londonderry

Massieville

Pleasant Valley

Richmond Dale

South Salem/Bourneville

Other (please specify)

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* 22. How far in advance do rides need to be scheduled?

Same Day

24 hours

48 hours

3 - 6 days

1 week

More than 1 week

Other (please specify)

Ross County COVID-19 Vaccine Transportation Options

Vaccination Transportation

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* 1. Transportation Provider Name

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* 2. Primary Contact

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* 3. Phone Number

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* 4. Primary Contact Email Address

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* 5. Current Days of Operation

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* 6. Monday - Friday Hours of Operation (N/A if none)

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* 7. Saturday Hours of Operation (N/A if none)

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* 8. Sunday Hours of Operation (N/A if none)

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* 9. Do you provide transportation for the general public, client only, or a specific population?

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* 10. Current fare cost

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* 11. Do you offer a discount for older adults?

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* 12. Do you offer a discount for individuals with disabilities?

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* 13. Do you offer discounts to anyone traveling to a vaccination site?

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* 14. Do you provide assistance to individuals that require assistance in walking or entering/exiting a vehicle?

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* 15. Are personal care attendants permitted to accompany riders free of charge?

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* 16. Do you currently operate wheelchair accessible vehicles?

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* 17. How many wheelchair accessible vehicles are currently in your fleet?

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* 18. Do you currently operate stretcher/cot transport vehicles?

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* 19. Do you provide Medicaid covered transportation?

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* 20. Do you accept private healthcare insurance?

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* 21. Which of the following areas are included in your current service area

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* 22. How far in advance do rides need to be scheduled?

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* 23. How do riders schedule a ride with you?

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* 24. Is there anything else we should know about transporting individuals for vaccines or any other type of service offered by your organization?