* 1. Do you live in a city, village or the country?

* 2. What city do you live closest to?

* 3. What year were you born?

* 4. Are you disabled?

Please mark how much you agree or disagree with the following statements:

* 5. “There is not enough public transportation.”

* 6. Transportation needs to be 24 hours a day.

* 7. Transportation needs to be nights and weekends but not 24 hours a day.

* 8. There needs to be work-related transportation.

Please mark how much you agree or disagree with the following statements:

* 9. There needs to be more medical-related transportation.

* 10. There needs to be more wheelchair transportation.

* 11. There needs to be door-to-door transportation for seniors and disabled.

* 12. There are areas of Wayne County that are underserved by transportation.

* 13. There needs to be more education on transportation services, programs and requirements.

* 14. Not being able to speak English is a problem for people who want to use transportation.

* 15. Using cabs and buses takes too much planning.

* 16. Wayne County needs more bicycle-friendly streets and lanes.

* 17. There needs to be more sidewalks and safe walkways.

* 18. Have you used transportation assistance (like cab or bus passes, gas cards, Medicaid trips, etc.?

* 19. If “Yes,” what was it for? (Pick as many as you need.)

* 20. What transportation assistance do you use or have used over the past year?

* 21. If you use transportation assistance, how many times a month do you use them?

* 22. Have you ever needed wheelchair transportation?

* 23. If you have ever needed wheelchair transportation, how hard was it to get?

* 24. If you used wheelchair transportation, who provided it?

* 25. Have you ever needed transportation assistance to get to another county?

* 26. If “Yes,” what county or counties did you go to?

* 27. If “Yes,” what was it for? (Pick as many as you need.)

* 28. Have you ever had trouble getting transportation to take a child somewhere?

* 29. If “Yes” what was the problem?

* 30. Did you ever lose a job because you did not have transportation?

* 31. Did you ever not take a job because you couldn’t get there?

* 32. Do you have anything else to say about public transportation?

* 33. If you would like to be interviewed about transportation in Wayne County, please give your name and contact information.

Thank you for completing this survey. If you need to return this survey by mail, please send it to:
Community Action Wayne/Medina
905 Pittsburgh Ave.
Wooster, OH 44691

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