Healthy Aging MV Transportation Survey

The purpose of this survey is to determine the needs of older adults for on-island transportation. Please fill out this survey for yourself or a loved one or friend (one survey per person, please). Mail the completed survey to Healthy Aging MV, 111 Edgartown Rd., Vineyard Haven MA 02568 or drop it off at your local Council on Aging. If you prefer, take the survey online at www.hamv.org. If you have questions, please call 508-693-7900 ext. 455.

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* 1. Please let us know who is filling out the survey:

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* 2. What is your age in years?

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* 3. Do you live on the Vineyard year-round?

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* 4. If not, what months do you live on-island?

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* 5. In what town or area do you reside?

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* 6. Is your home or residence

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* 7. Which form(s) of transportation do you currently use? (mark all that apply):

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* 8. If you currently use a paid service, how much, on average, do you pay for a one-way trip?

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* 9. How many days per week do you need transportation service?

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* 10. Do you usually purchase an annual VTA bus pass?

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* 11. When you travel

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* 12. Are you homebound?

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* 13. If you used a transportation service that picked you up at your home and was on-call or could be scheduled, where would you be most likely to go? (check all that apply)

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* 14. When do you most need transportation support? (check all that apply)

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* 15. How much are you willing to pay for a transportation service that is on-call (or can be scheduled) and pick you up at your home?

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* 16. Would you be interested in a service to take you to the nearest bus stop?

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* 17. Do you have a vehicle but only need a driver?

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* 18. Do you require assistance boarding a van or bus?

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* 19. Are you at risk of having to move away from the Island because of:

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* 20. Sign me up to receive Healthy Aging MV newsletters and emails.

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