Transportation Needs Assessment Survey This short survey is sponsored by Dallas County Public Health Nursing Services. We appreciate your help in learning more about the need for and use of public transportation services in our communities. Please answer the questions below to the best of your ability. Thank you for your help! Question Title * 1. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305) Question Title * 2. Do you have a driver's license? Yes No Question Title * 3. Do others in your home have a valid driver's license? Yes No How many others? Question Title * 4. Do you own at least one working vehicle? Yes No Question Title * 5. How often do you rely on or use public transportation? Daily Weekly Monthly Seldom Never Question Title * 6. Which of the following transportation services have you used? Taxi Service Joy Ride HIRTA DART Rides from friends or relatives None Other (please specify) Question Title * 7. For what purposes have you used public transportation? Medical Appointments Employment Education Personal Needs Groceries Don't use it Other (please specify) Question Title * 8. What times of day would you need or use public transportation? Early Morning (5 am to 10 am) Mid-day (10 am to 4 pm) Evening (4 pm to 9 pm) Late Night (9 pm to 5 am) Not at all Question Title * 9. What issues, if any, prevent you from using public transportation? I don't know how I didn't know it was available I can't afford to use it It doesn't go to the destinations that I need It is inconvenient I don't need it and I am not interested Other (please specify) Question Title * 10. If you were to use public transportation, which of the following options would you be interested in? Catch a bus at a bus stop Call ahead for a ride (curb-to-curb) Call ahead for a ride (door-to-door) Not interested How often would you use public transportation in this way? Question Title * 11. From the list below, select the appointments you missed and/or trips you could not take over the last 6 months, due to lack of transportation. Senior nutrition/ activity center School Social Service Appointment Kids' activities Job Religious event Social event/ entertainment Visiting friends or family Shopping Medical appointments Didn't miss any; doesn't apply to me Other (please specify) Done