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Facilitating Access to Coordinated Transportation (FACT)

Client Demographic Survey

*Please take a few moments to complete the following questions. Submittal of this information is voluntary. Your feedback is very important and we appreciate your participation! 
1.What is your sex?
2.What is your race?
3.Do you have a disability?
4.What is your age?
5.How many people live in your household?
6.What is your household's total annual income?
7.What language is primarily spoken in your household?
8.On average, how many times a month do you access transportation services provided by FACT?