Reeve Foundation Survey for Potential App Users

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* 1. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544) If outside the USA, please supply the country code (for example, UK +44)

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* 2. What is your preferred language?

Arabic

Armenian

Chinese

English

French

French Creole

German

Greek

Gujarati

Hindi

Italian

Japanese

Korean

Persian

Polish

Portuguese

Russian

Spanish

Tagalog

Urdu

Vietnamese

Other (please specify)

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* 3. What is your gender identity?

Male

Female

Prefer not to disclose

__________ (fill in the blank)

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* 4. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 5. What type of mobile device do you PRIMARILY use?

Regular cell/mobile phone (not a smartphone)

Android

iPhone

Blackberry/RIM

Windows Mobile

iPad

Tablet

I don't have a mobile phone

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* 6. Do you prefer to use your existing account profile (i.e. Facebook, Gmail, etc.) when logging into an application and/or website?

Yes

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* 7. If yes, please rank the following applications in order from most preferable (1) to the least (3).

Facebook

Gmail

Other

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* 8. From which sources do you primarily obtain information about accessibility when you plan outings around town, such as restaurants, nightlife, parks, etc…? (Select as many as appropriate).

I do not plan the trips

Travel agent

Internet - from discount accommodation website

Internet - TripAdvisor/Yelp/Hotels.com

Internet - Other: provide website information in the comment box below

Email inquiry direct to accommodation provider

Phone inquiry direct to accommodation provider

Hotel chain - always book through one hotel chain

Tourist office/Visitor information center/Government tourism commission

Airline packaged deals that include accommodation

Generic travel book or guide

Word of mouth from friends or relatives

I only stay at places that I have stayed at before

Other (please specify)

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* 9. Which of the following list of access dimensions is/are applicable (Select all that apply).

Mobility - requiring use of a power wheelchair

Mobility - requiring use of a manual wheelchair

Mobility - requiring use of other mobility aids

Mobility - no aid required but a mobility limitation, i.e. able to cover a limited distance

Mobility - scooter

Other (please specify)

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* 10. How would you describe your level of support needs in everyday living? (Select the appropriate response)

None

Low

Medium

High

Very High (requires full time attendant)

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* 11. Where is your favorite vacation destination(s)?

City

Country

Mountains

Beach

Other (please specify)

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* 12. Do you travel to primaily travel domestically or internationally?

Domestic (U.S.)

International

Both

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* 13. What are your favorite activities while on vacation?

Tourist attractions

Shopping

Eating

Outdoor adventures

Relaxation & pampering

Whatever opportunity presents itself

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* 14. What are the next three traveling destinations on your bucket list?

Choice #1:

Choice #2:

Choice #3:

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* 15. Do you have any frustrations when searching for travel destinations?

Yes

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* 16. If yes, please specify the most problematic frustrations. (Note answer in space provided.)

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* 17. What are your top three favorite travel websites for finding information about facility accessibilities?

Choice #1:

Choice #2:

Choice #3:

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* 18. Please indicate on the 5 point scale, how important the following attributes are to you in making a decision on whether a room is appropriate for your needs (please select a response for each attribute).

	Not at all important	Not important	Neutral	Important	Very Important
Designated accessible parking spaces	Designated accessible parking spaces Not at all important	Designated accessible parking spaces Not important	Designated accessible parking spaces Neutral	Designated accessible parking spaces Important	Designated accessible parking spaces Very Important
An intercom at an accessible height at the entrance/reception	An intercom at an accessible height at the entrance/reception Not at all important	An intercom at an accessible height at the entrance/reception Not important	An intercom at an accessible height at the entrance/reception Neutral	An intercom at an accessible height at the entrance/reception Important	An intercom at an accessible height at the entrance/reception Very Important
Entrance that offers independent access (automatic doors)	Entrance that offers independent access (automatic doors) Not at all important	Entrance that offers independent access (automatic doors) Not important	Entrance that offers independent access (automatic doors) Neutral	Entrance that offers independent access (automatic doors) Important	Entrance that offers independent access (automatic doors) Very Important
Split-level/Dual-height reception desk	Split-level/Dual-height reception desk Not at all important	Split-level/Dual-height reception desk Not important	Split-level/Dual-height reception desk Neutral	Split-level/Dual-height reception desk Important	Split-level/Dual-height reception desk Very Important
Clear signage indicating accessible areas/features	Clear signage indicating accessible areas/features Not at all important	Clear signage indicating accessible areas/features Not important	Clear signage indicating accessible areas/features Neutral	Clear signage indicating accessible areas/features Important	Clear signage indicating accessible areas/features Very Important
Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool)	Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool) Not at all important	Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool) Not important	Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool) Neutral	Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool) Important	Continuous accessible path of travel to all public areas (lounges, conference facilities, gym and swimming pool) Very Important
Handrails throughout facility	Handrails throughout facility Not at all important	Handrails throughout facility Not important	Handrails throughout facility Neutral	Handrails throughout facility Important	Handrails throughout facility Very Important
Seats near the elevator at the foyer and on all floors	Seats near the elevator at the foyer and on all floors Not at all important	Seats near the elevator at the foyer and on all floors Not important	Seats near the elevator at the foyer and on all floors Neutral	Seats near the elevator at the foyer and on all floors Important	Seats near the elevator at the foyer and on all floors Very Important
Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms	Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms Not at all important	Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms Not important	Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms Neutral	Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms Important	Accessible guest rooms that offer equal level of comfort and amenity as non-accessible rooms Very Important
Easily operated door handles (e.g. D-handles)	Easily operated door handles (e.g. D-handles) Not at all important	Easily operated door handles (e.g. D-handles) Not important	Easily operated door handles (e.g. D-handles) Neutral	Easily operated door handles (e.g. D-handles) Important	Easily operated door handles (e.g. D-handles) Very Important
Switches, door handles, and temperature controls located (35-43 in) above floor level	Switches, door handles, and temperature controls located (35-43 in) above floor level Not at all important	Switches, door handles, and temperature controls located (35-43 in) above floor level Not important	Switches, door handles, and temperature controls located (35-43 in) above floor level Neutral	Switches, door handles, and temperature controls located (35-43 in) above floor level Important	Switches, door handles, and temperature controls located (35-43 in) above floor level Very Important
In-room tea/coffee making facilities reachable/useable from a seated position	In-room tea/coffee making facilities reachable/useable from a seated position Not at all important	In-room tea/coffee making facilities reachable/useable from a seated position Not important	In-room tea/coffee making facilities reachable/useable from a seated position Neutral	In-room tea/coffee making facilities reachable/useable from a seated position Important	In-room tea/coffee making facilities reachable/useable from a seated position Very Important
Bar fridge for storing medication	Bar fridge for storing medication Not at all important	Bar fridge for storing medication Not important	Bar fridge for storing medication Neutral	Bar fridge for storing medication Important	Bar fridge for storing medication Very Important
Flexible bed configuration/movable bed	Flexible bed configuration/movable bed Not at all important	Flexible bed configuration/movable bed Not important	Flexible bed configuration/movable bed Neutral	Flexible bed configuration/movable bed Important	Flexible bed configuration/movable bed Very Important
Under bed clearance between floor & bed base for a hoist (5 in)	Under bed clearance between floor & bed base for a hoist (5 in) Not at all important	Under bed clearance between floor & bed base for a hoist (5 in) Not important	Under bed clearance between floor & bed base for a hoist (5 in) Neutral	Under bed clearance between floor & bed base for a hoist (5 in) Important	Under bed clearance between floor & bed base for a hoist (5 in) Very Important
Appropriate bed height (19-21 in)	Appropriate bed height (19-21 in) Not at all important	Appropriate bed height (19-21 in) Not important	Appropriate bed height (19-21 in) Neutral	Appropriate bed height (19-21 in) Important	Appropriate bed height (19-21 in) Very Important
Firm mattress	Firm mattress Not at all important	Firm mattress Not important	Firm mattress Neutral	Firm mattress Important	Firm mattress Very Important
All lights, television, telephone and other room controls accessible and visible by a person lying in the bed	All lights, television, telephone and other room controls accessible and visible by a person lying in the bed Not at all important	All lights, television, telephone and other room controls accessible and visible by a person lying in the bed Not important	All lights, television, telephone and other room controls accessible and visible by a person lying in the bed Neutral	All lights, television, telephone and other room controls accessible and visible by a person lying in the bed Important	All lights, television, telephone and other room controls accessible and visible by a person lying in the bed Very Important
Non-slip bathroom floor	Non-slip bathroom floor Not at all important	Non-slip bathroom floor Not important	Non-slip bathroom floor Neutral	Non-slip bathroom floor Important	Non-slip bathroom floor Very Important
Call/Emergency button in the bathroom	Call/Emergency button in the bathroom Not at all important	Call/Emergency button in the bathroom Not important	Call/Emergency button in the bathroom Neutral	Call/Emergency button in the bathroom Important	Call/Emergency button in the bathroom Very Important
Grab rails in the bathroom and toilet (31 inch)	Grab rails in the bathroom and toilet (31 inch) Not at all important	Grab rails in the bathroom and toilet (31 inch) Not important	Grab rails in the bathroom and toilet (31 inch) Neutral	Grab rails in the bathroom and toilet (31 inch) Important	Grab rails in the bathroom and toilet (31 inch) Very Important
Roll in hobless shower entry (no raised edge)	Roll in hobless shower entry (no raised edge) Not at all important	Roll in hobless shower entry (no raised edge) Not important	Roll in hobless shower entry (no raised edge) Neutral	Roll in hobless shower entry (no raised edge) Important	Roll in hobless shower entry (no raised edge) Very Important
Pull-down bench in shower	Pull-down bench in shower Not at all important	Pull-down bench in shower Not important	Pull-down bench in shower Neutral	Pull-down bench in shower Important	Pull-down bench in shower Very Important
Handheld shower head with a long hose (6 feet)	Handheld shower head with a long hose (6 feet) Not at all important	Handheld shower head with a long hose (6 feet) Not important	Handheld shower head with a long hose (6 feet) Neutral	Handheld shower head with a long hose (6 feet) Important	Handheld shower head with a long hose (6 feet) Very Important
Lever action mixing water taps	Lever action mixing water taps Not at all important	Lever action mixing water taps Not important	Lever action mixing water taps Neutral	Lever action mixing water taps Important	Lever action mixing water taps Very Important
Accessible height vanity unit	Accessible height vanity unit Not at all important	Accessible height vanity unit Not important	Accessible height vanity unit Neutral	Accessible height vanity unit Important	Accessible height vanity unit Very Important
Toilet seat between (18-19 inch) in height from the floor	Toilet seat between (18-19 inch) in height from the floor Not at all important	Toilet seat between (18-19 inch) in height from the floor Not important	Toilet seat between (18-19 inch) in height from the floor Neutral	Toilet seat between (18-19 inch) in height from the floor Important	Toilet seat between (18-19 inch) in height from the floor Very Important
Clear circulation space between the toilet and the walls/door to allow for transfers	Clear circulation space between the toilet and the walls/door to allow for transfers Not at all important	Clear circulation space between the toilet and the walls/door to allow for transfers Not important	Clear circulation space between the toilet and the walls/door to allow for transfers Neutral	Clear circulation space between the toilet and the walls/door to allow for transfers Important	Clear circulation space between the toilet and the walls/door to allow for transfers Very Important
Table/Kitchen bench with an underside clearance (31 in)	Table/Kitchen bench with an underside clearance (31 in) Not at all important	Table/Kitchen bench with an underside clearance (31 in) Not important	Table/Kitchen bench with an underside clearance (31 in) Neutral	Table/Kitchen bench with an underside clearance (31 in) Important	Table/Kitchen bench with an underside clearance (31 in) Very Important
Orientation to the room, establishment and surrounding areas by a knowledgeable staff member	Orientation to the room, establishment and surrounding areas by a knowledgeable staff member Not at all important	Orientation to the room, establishment and surrounding areas by a knowledgeable staff member Not important	Orientation to the room, establishment and surrounding areas by a knowledgeable staff member Neutral	Orientation to the room, establishment and surrounding areas by a knowledgeable staff member Important	Orientation to the room, establishment and surrounding areas by a knowledgeable staff member Very Important
Emergency evacuation orientation	Emergency evacuation orientation Not at all important	Emergency evacuation orientation Not important	Emergency evacuation orientation Neutral	Emergency evacuation orientation Important	Emergency evacuation orientation Very Important
Assistance getting luggage to & from room	Assistance getting luggage to & from room Not at all important	Assistance getting luggage to & from room Not important	Assistance getting luggage to & from room Neutral	Assistance getting luggage to & from room Important	Assistance getting luggage to & from room Very Important
Illuminated switches	Illuminated switches Not at all important	Illuminated switches Not important	Illuminated switches Neutral	Illuminated switches Important	Illuminated switches Very Important
Room near elevator	Room near elevator Not at all important	Room near elevator Not important	Room near elevator Neutral	Room near elevator Important	Room near elevator Very Important
Emergency phone in elevator	Emergency phone in elevator Not at all important	Emergency phone in elevator Not important	Emergency phone in elevator Neutral	Emergency phone in elevator Important	Emergency phone in elevator Very Important
Room service	Room service Not at all important	Room service Not important	Room service Neutral	Room service Important	Room service Very Important
Low pile carpet or easy push floor surface (tiles, lino, etc.)	Low pile carpet or easy push floor surface (tiles, lino, etc.) Not at all important	Low pile carpet or easy push floor surface (tiles, lino, etc.) Not important	Low pile carpet or easy push floor surface (tiles, lino, etc.) Neutral	Low pile carpet or easy push floor surface (tiles, lino, etc.) Important	Low pile carpet or easy push floor surface (tiles, lino, etc.) Very Important
Pool with access provisions	Pool with access provisions Not at all important	Pool with access provisions Not important	Pool with access provisions Neutral	Pool with access provisions Important	Pool with access provisions Very Important
Gym with access provisions	Gym with access provisions Not at all important	Gym with access provisions Not important	Gym with access provisions Neutral	Gym with access provisions Important	Gym with access provisions Very Important
Self serve laundry with access provisions	Self serve laundry with access provisions Not at all important	Self serve laundry with access provisions Not important	Self serve laundry with access provisions Neutral	Self serve laundry with access provisions Important	Self serve laundry with access provisions Very Important
Catering for dietary considerations	Catering for dietary considerations Not at all important	Catering for dietary considerations Not important	Catering for dietary considerations Neutral	Catering for dietary considerations Important	Catering for dietary considerations Very Important

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* 19. Which of the following do you require if traveling away from home for an overnight stay? (Select as many as appropriate)

Oxygen or respiration equipment

Shower seat/chair

Commode

Hoist

Hospital bed

Mattress overlay

Modified vehicles (special purpose or hand controls)

Travel companion/guide

Personal care attendant - to travel with

Personal care attendant - at destination

Service animal

None of the above

Other (please specify)

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* 20. Have there been any types of accommodation that you have been unable to stay at due to a lack of accessibility? (Select appropriate response)

Yes

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* 21. If yes, what were the types of accommodation and how did this affect your choice? (Note answer in space provided.)

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* 22. How often do you travel away from home for at least one night? (Select the most appropriate response)

Less than once a year

Once a year

2-3 times a year

4-6 times a year

More than 6 times a year

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* 23. With what kind of group/s do you normally travel with? (Select as many as appropriate)

Self

Partner

Friends

Parents and children

Business associate

Couple with other adults (no children)

Specific disability group

Organized tour group

With attendant

Other (please specify)

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* 24. Are you satisfied with your current level of travel? (Select the appropriate response)

	Not at all satisfied	Not satisfied	Neutral	Satisfied	Very satisfied
Current level of travel	Current level of travel Not at all satisfied	Current level of travel Not satisfied	Current level of travel Neutral	Current level of travel Satisfied	Current level of travel Very satisfied

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* 25. If you are not traveling as often as you would like, what are the major reasons? (Select as many responses as appropriate)

Difficulty of the pre-planning requirements

Previous problems encountered

Lack of suitable accommodation

Lack of accessible destinations

Lack os accessible attractions

Transport problems getting to destinations

Transport problems at destinations

Difficulties in obtaining accurate information

Problems with how information is made available

Lack of suitable attendants

Additional cost of attendants

General cost/economic constraints

I don't like traveling

Health issues prevent me from traveling

Other (please specify)