Transportation Survey - Medical Question Title * 1. Do you currently use public or shared transportation? (Check all that apply) Train/commuter rail MART bus/van Council on Aging van Taxi Carpool/ride with family or friends Other Do not use Other (please specify) OK Question Title * 2. If it were an option, would you ever consider taking public or shared transportation to medical appointments? Yes No OK Question Title * 3. If you answered “Yes” to Question #2a. what factors would be most important to you? (Check all that apply) Cost Effective Time saving compared with other options Reliable Multiple pickup/drop off times OK Question Title * 4. If you answered "Yes" to Question #2b. what types of transportation would you be most interested in? (Check all that apply) Bus Company run shuttle with my co-workers Connecting service to train Uber or on-demand ride service OK Question Title * 5. If you answered "No" to Question #2Why not? Public transportation is not available when I need it Public transportation is unreliable I don’t trust other drivers Other (please specify) OK Question Title * 6. Is transportation a major factor in whether or not you would schedule a medical appointment? Yes No OK Question Title * 7. Have you ever avoided scheduling a medical appointment because it was hard for you to get there? Yes No OK Question Title * 8. How often would you take public or shared transportation to/from medical appointments? Every day A few times a week Once a week Once in a while OK Question Title * 9. How much are you willing to pay for a one-way ride to or from a medical appointment? (Mark the maximum amount you would be willing to pay) $1.00 $1.50 $2.00 $2.50 $3.00 $5.00 or more OK Question Title * 10. How much time are you willing to spend on a one-way trip to your medical appointment? Less than 30 min Less than 1 hour 1 hour or more OK Question Title * 11. How would you prefer to schedule public or shared transportation? Call or book online at least 24 hours in advance Call or book online on demand/as needed Arrive at a stop/station at posted times Custom plan a route from available options online OK Question Title * 12. Which zip code do you live in? OK Question Title * 13. Do you or would you use public or shared transportation for reasons other than medical appointments? (check all that apply) Shopping Work Entertainment outings No OK Question Title * 14. If you do not drive, why? Physical limitations or disability Developmental/Learning/Psychiatric condition or disability Cost of owning/maintaining a vehicle Do not possess a valid driver’s license Other (please specify) OK Question Title * 15. If used by your family, in what zip code(s) are your medical appointments? OK Question Title * 16. Are you eligible to receive SSI, Social Security Disability, MassHealth, SNAP, or other benefits with income guidelines? Yes No OK Question Title * 17. Do you speak English as a second language (ESL)? Yes No If yes, what language? OK Question Title * 18. I am: Male Female Non-Binary OK Question Title * 19. What is your race/ethnicity? African American/black American Indian/Alaska Native Asian Middle Eastern Caucasian/white Hispanic/white Hispanic/black Native Hawaiian/Pacific Islander OK Question Title * 20. Including yourself, how many people live in your household? Number of children under 18 Number of adults 18-64 Number of adults 65 and older OK Question Title * 21. What is your average annual household income? $0–$15,000 $15,001–$25,000 $25,001–$35,000 $35,001–$50,000 $50,000+ Don’t know No response OK Question Title * 22. Please list any suggestions to improve transportation services: OK DONE