Healthy Choices/Healthy Communities Coalition

The purpose of this survey is to identify transportation barriers and challenges in your community. The Reach Appalachia initiative aims to include seniors, caregivers and individuals with disabilities the opportunity to have their voices heard and participate in both advisory and decision making roles. Through this initiative we hope to produce a more comprehensive and coordinated transportation plan that serves everyone in our region. All survey responses are confidential. Thank you for your participation!

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* 1. What is your primary source of transportation?

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* 2. Is it ever difficult for you to find transportation?

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* 3. Please enter your zip code

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* 4. In what part of town do you live?

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* 5. Have you ever used a transportation service? (i.e. public bus system; medicab; taxi; hospital van ministry, etc.)

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* 6. In a typical week how often do you use this type of service?

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* 7. What do you need transportation for the most? (please check all that apply)

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* 8. Are you a senior citizen?

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* 9. Do you have a physical or mental disability?

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* 10. Are you a caregiver for a senior or individual with a disability?

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* 11. How may transportation services be improved in your community?

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* 12. Your survey responses above are confidential. The Reach Appalachia initiative aims to include seniors, caregivers and individuals with disabilities the opportunity to participate in both advisory and decision making roles. If you would like to be involved  or want more information about this project  please provide your contact information below. The information you provide will not be linked to your survey responses. Thank you for taking the survey.

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