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* 1. Do you, personally, face any difficulties or issues that affect your mobility?:

If you live in or often visit the Cotswolds, Cotswold District Council would like to know what you think about transport needs in the area and how transport could be improved both for getting around within the area and to nearby towns.
To tell us more about transport needs for residents and those working/visiting the Cotswolds. Please fill in this short, simple tick box, questionnaire. The deadline for returning the survey is the end of April 2015.
* Indicates a response is required

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* 2. Do you regularly use any of the following to get around the Cotswolds area (please tick up to 3 boxes)?:

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* 3. What are the main reasons you choose to use the transport mode/s you do (please tick up to 3 boxes)?:

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* 4. Do you have any difficulties getting around the Cotswolds area (please tick only 1 box)?:

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* 5. What are the main problems you have getting around (please tick up to 3 boxes)?:

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* 6. Where do you most need to get to, but can’t do so easily (please tick only 1 box)?:

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* 7. Why do you need to go there (please tick only 1 box)?:

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* 8. How often do you need to go there (please tick only 1 box)?:

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* 9. When do you need to go there (please tick only 1 box)?:

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* 10. When do you need to return from there (please tick only 1 box)?:

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* 11. Is there anywhere else you particularly need to get to, but can’t do so easily (please tick only 1 box)?:

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* 12. Why do you need to go there (please tick only 1 box)?:

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* 13. How often do you need to go there (please tick only 1 box)?:

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* 14. When do you need to go there (please tick only 1 box)?:

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* 15. When do you need to return from there (please tick only 1 box)?:

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* 16. Are there any other places you particularly need to get to, but can't do so easily (please tell us where, when and how often you need to go)?:

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* 17. What would help to overcome your difficulties getting to these places (please tick up to 3 boxes)?:

Several Community Transport projects in the Cotswolds area currently provide Dial a Ride, Community Bus, Volunteer Car services and transport for Community Groups, often on a pre-booked basis.
(You can find out more at http://www.gloucestershire.gov.uk/CHttpHandler.ashx?id=51977&p=0 and http://www.gloucestershire.gov.uk/extra/article/110240/Community-transport).

The following three questions relate specifically to services provided by Community Transport

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* 18. Are you aware of the Community Transport provision available in your area?:

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* 19. If you have never used Community Transport or only use it occasionally why is this (please tick only one box)?:

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* 20. What could be done to improve Community Transport (please tick up to three boxes)?:

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* 21. Please tell us anything else about your transport needs or the solutions/improvements to public transport and/or community transport you would like to see in the Cotswolds area?:

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* 22. Are you?:

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* 23. Please tell us your age. Are you?:

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* 24. Do you consider yourself disabled?:

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* 25. Please tell us the name of the town or village where you live?:

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* 26. Please tell us your postcode?:

Thank you for taking the time to complete this questionnaire. All information collected is anonymous.

Data Protection Statement: The Council will only use the information gathered on this form for the purpose of carrying out the consultation process. We may pass on certain details to other Council Services and other partner agencies as required. However we will not disclose it to any other third party, except where required by law.

Cotswold District Council and its partners are committed to involving everyone who has an interest in the Cotswolds area and we will do this by making sure that we talk with and listen to you, but don’t repeatedly ask you the same questions. Therefore, whilst we will not share your personal data, the ideas and feedback you give us may also be used to inform other relevant projects or plans.

We are happy to provide this survey in alternative formats and languages

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If you require any further information about this survey, please contact: Cotswold District Council on 01285 623566 or the consultant Paul Beecham on 07580 305269 or by email at: pbeecham0@aol.com

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