PICK MOD Survey
1.
WHERE DO YOU LIVE?
Atoka
Bartlesville
Claremore
Collinsville
Eufaula
Grove
Madill
Miami
Owasso
Ponca City
Poteau
Pryor
Sallisaw
Sallisaw
Sapulpa
Skiatook
Sulphur
Tahlequah
Tishomingo
Vinita
Other (please specify)
2.
PLEASE INDICATE YOUR AGE
16 - 19
20 - 29
30 - 59
60+
Prefer Not to Say
3.
PLEASE INDICATE YOUR GENDER
Male
Female
Transgender Male
Transgender Female
Prefer Not to Say
4.
PLEASE INDICATE YOUR RACE
Caucasian
African American
Native American
Hispanic/Latino
Other (please specify)
5.
EMPLOYMENT STATUS
Employed Full Time
Employed Part Time
Full Time Student
Part Time Student
Unemployed
Retired
6.
HOW OFTEN DO YOU USE PICK?
Once or Twice a Week
More than Three Times a Week
Once or Twice a Month
More than 3 Times a Month
I never use PICK
7.
WHAT ARE THE MAIN PURPOSES OF YOUR TRIPS?
Work
Education
Child Care
Medical
Groceries/Food
Religious Services
Recreation
Local Businesses/Shopping
Other (please specify)
8.
HOW DO YOU SCHEDULE YOUR PICK TRIP?
Uber App
Call Center
9.
WOULD YOU LIKE TO USE PICK DURING THE DAY INSTEAD OF YOUR REGULAR TRANSIT SERVICE?
Yes
No
Unsure
10.
HAS PICK IMPROVED YOUR QUALITY OF LIFE?
Yes
No
Unsure
11.
HOW DOES PICK SERVICES AFFECT YOUR FAMILY?
Positively
Negatively
No Change
Prefer not to answer
12.
PLEASE SELECT THE ANSWER THAT BEST DESCRIBES YOUR SATISFACTION WITH PICK IN EACH AREA:
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Ease of Getting Information
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Ease of using the Uber App to Schedule a Ride
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Ease of using the Call Center to Schedule a Ride
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Courtesy of Driver
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Cleanliness of Vehicles (inside and outside)
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Sense of Personal Safety
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Vehicle On Time Performance
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Comfort Level
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Service Hours Offered
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
13.
DID YOU HAVE ANY BARRIERS THAT PREVENT YOU FROM ACCESSING PICK SERVICES?
Language (interpreter needed)
Physical Limitations
No/None
14.
HOW DID YOU LEARN ABOUT PICK?
Family/Friend
Social Media
Walk-In
Referred by other agency
Internet/Website
Newspaper/Radio/TV
Flyer/Brochure
Other (please specify)
15.
DO YOU HAVE ANY SUGGESTIONS HOW WE COULD IMPROVE THE SERVICES WE PROVIDED TO YOU?
Current Progress,
0 of 15 answered