Veteran Transit Assessment - Viewpoint of Veterans

Thank you for participating in this short survey. The information you provide will be used to update the Coos County Veterans Transportation Needs Assessment. Please fill out each question to the best of your ability. Thank you for your participation. All surveys will be kept anonymous.

Disclaimer: Please only take this survey if you are a United States Military Veteran living in Coos County, Oregon. We also ask that you do not fill out this survey if you have already done so.

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* 1. What is your age?

18-24

25-34

35-44

45-54

55-64

65+

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* 2. What is your gender?

Female

Male

Other

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* 3. In which branch(es) of the military did you serve? Select all that apply.

Army

Marine Corps

Navy

Air Force

Coast Guard

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* 4. In what war era(s) did you serve? Select all that apply.

WWII

Korea

Vietnam

Post-Vietnam

Gulf War

War on Terrorism (OIF, OEF, etc.)

Other

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* 5. Do you have a disability, and is it service connected

Yes, and it is service connected

Yes, but it is not service connected

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* 6. Do you receive healthcare from the VA?

Yes

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* 7. If you do receive VA healthcare, approximately how many times do you

go?

Once a week or more.

Less than once a week, more than once a month.

Approximately once a month.

Less than once a month, more than once a year.

Once a year or less.

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* 8. If you receive VA healthcare, at what location? Select all that apply.

North Bend

Roseburg

Eugene

Other (please specify)

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* 9. Please list your 3 most traveled destinations. (Examples: VA Roseburg,
Work, School, Grocery Store, Case Management, etc.)

Destination 1

Destination 2

Destination 3

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* 10. Please select every type of transportation you have used in the past 6 months.

Public Transit

Medicaid Transportation

Taxi

Friend or Family Drives You

Personal Vehicle

Community Transportation (Senior Services)

Other (please specify)

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* 11. What are your top 3 most used transportation modes? (ex: Bus,
Personal Vehicle, Taxi, Walk, etc.)

Mode 1

Mode 2

Mode 3

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* 12. What are the biggest challenges you experience with transportation?
(Examples: Cost, getting to work, uncomfortable with bus, etc.)

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* 13. What type of technology do you use to go on the Internet? Mark all that apply.

Personal smart phone

Personal tablet, laptop, or computer

Public computer, tablet, laptop (Ex: Library, Agency, etc.)

I rarely use the Internet.

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* 14. What other sources do you use to get information about transportation? Select all that apply.

I ask a family member or friend.

I call a phone number.

I ask my case manager, or agency.

I ask a friend from a Veteran Service Organization I belong to.

Other (please specify)

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* 15. Please list the specific websites that you use to find information about
transportation or Veteran human services.

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* 16. What describes the most important factor in choosing a transportation
mode? (Example, convenience, cost, handicap accessible, etc. )

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* 17. What types of transportation assistance would be valuable to you?

Someone to show me how to use transportation services

Information about these services located at Veterans Associations

Veterans Medical Facilities and VFWs

Website describing and facilitating access to transportation services

Informative Emails

Information delivered by standard mail

A mobile app that allows access to regional transportation information on your cellular smart phone

Other (please specify)

Veteran Transit Assessment - Viewpoint of Veterans

Question Title

* 1. What is your age?

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* 2. What is your gender?

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* 3. In which branch(es) of the military did you serve? Select all that apply.

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* 4. In what war era(s) did you serve? Select all that apply.

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* 5. Do you have a disability, and is it service connected

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* 6. Do you receive healthcare from the VA?

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* 7. If you do receive VA healthcare, approximately how many times do you

go?

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* 8. If you receive VA healthcare, at what location? Select all that apply.

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* 9. Please list your 3 most traveled destinations. (Examples: VA Roseburg,
Work, School, Grocery Store, Case Management, etc.)

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* 10. Please select every type of transportation you have used in the past 6 months.

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* 11. What are your top 3 most used transportation modes? (ex: Bus,
Personal Vehicle, Taxi, Walk, etc.)

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* 12. What are the biggest challenges you experience with transportation?
(Examples: Cost, getting to work, uncomfortable with bus, etc.)

Question Title

* 13. What type of technology do you use to go on the Internet? Mark all that apply.

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* 14. What other sources do you use to get information about transportation? Select all that apply.

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* 15. Please list the specific websites that you use to find information about
transportation or Veteran human services.

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* 16. What describes the most important factor in choosing a transportation
mode? (Example, convenience, cost, handicap accessible, etc. )

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* 17. What types of transportation assistance would be valuable to you?

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* 18. If Coos County Area Transportation District did not receive funding for Veteran Transportation Services, how would that impact you?

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* 19. Is there anything you would like to add that you feel would be helpful in meeting your transportation needs?

Veteran Transit Assessment - Viewpoint of Veterans

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* 1. What is your age?

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* 2. What is your gender?

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* 3. In which branch(es) of the military did you serve? Select all that apply.

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* 4. In what war era(s) did you serve? Select all that apply.﻿

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* 5. Do you have a disability, and is it service connected

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* 6. Do you receive healthcare from the VA?

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* 7. If you do receive VA healthcare, approximately how many times do yougo?

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* 8. If you receive VA healthcare, at what location? Select all that apply.

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* 9. Please list your 3 most traveled destinations. (Examples: VA Roseburg,Work, School, Grocery Store, Case Management, etc.)

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* 10. Please select every type of transportation you have used in the past 6 months.

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* 11. What are your top 3 most used transportation modes? (ex: Bus, Personal Vehicle, Taxi, Walk, etc.)

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* 12. What are the biggest challenges you experience with transportation? (Examples: Cost, getting to work, uncomfortable with bus, etc.)

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* 13. What type of technology do yo﻿u use to go on the Internet? Mark all that apply.

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* 14. What other sources do you use to get information about transportation? Select all that apply.

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* 15. Please list the specific websites th﻿at you use to find information about transportation or Veteran human services.

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* 16. What describes the most important factor in choosing a transportation mode? (Example, convenience, cost, handicap accessible, etc. )

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* 17. What types of transportation assistance would be valuable to you?

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* 18. If Coos County Area Transportation District did not receive funding for Veteran Transportation Services, how would that impact you?

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* 19. Is there anything you would like to﻿ add that you feel would be helpful in meeting your transportation needs?

* 4. In what war era(s) did you serve? Select all that apply.

* 7. If you do receive VA healthcare, approximately how many times do you

go?

* 9. Please list your 3 most traveled destinations. (Examples: VA Roseburg,
Work, School, Grocery Store, Case Management, etc.)

* 11. What are your top 3 most used transportation modes? (ex: Bus,
Personal Vehicle, Taxi, Walk, etc.)

* 12. What are the biggest challenges you experience with transportation?
(Examples: Cost, getting to work, uncomfortable with bus, etc.)

* 13. What type of technology do you use to go on the Internet? Mark all that apply.

* 15. Please list the specific websites that you use to find information about
transportation or Veteran human services.

* 16. What describes the most important factor in choosing a transportation
mode? (Example, convenience, cost, handicap accessible, etc. )

* 19. Is there anything you would like to add that you feel would be helpful in meeting your transportation needs?