Transportation Survey - Elderly Question Title * 1. Do you currently use public or shared transportation? (Check all that apply) Train/commuter rail MART bus/van Council on Aging van Taxi Carpool/ride with family or friends Other Do not use Other (please specify) OK Question Title * 2. If it were an option, would you ever consider taking public or shared transportation to medical appointments? Yes No OK Question Title * 3. If you answered “Yes” to Question #2a. what factors would be most important to you? (Check all that apply) Cost Effective Time saving compared with other options Reliable Multiple pickup/drop off times OK Question Title * 4. If you answered "Yes" to Question #2b. what types of transportation would you be most interested in? (Check all that apply) Bus Company run shuttle with my co-workers Connecting service to train Uber or on-demand ride service OK Question Title * 5. If you answered "No" to Question #2Why not? Public transportation is not available when I need it Public transportation is unreliable I don’t trust other drivers Other (please specify) OK Question Title * 6. Are you currently able to drive? Yes No OK Question Title * 7. Are there any conditions in which you would prefer not to drive (check all that apply)? At night To an area of town that I do not know very well Destination more than 3 miles away Medical appointment when I'm not feeling well On high speed highways or freeways I don't drive to any destinations OK Question Title * 8. During the past 3 months, were you unable to travel to any of the following destinations because you did not have access to transportation (either your own car or a ride)? Shopping, grocery store, bank Medical/dental appointments Religious service Work Social outings (friends or relatives home, restaurant, golf, etc.) School OK Question Title * 9. Is transportation a major factor in whether or not you would schedule a medical appointment? Yes No OK Question Title * 10. Which of the following statements about your local public transportation system are true for you (check all that apply)? I'm unaware of a public transportation system I cannot afford it Not enough information about times, routes, etc. Cannot accommodate my wheelchair I do not wish to use it Other (please specify) OK Question Title * 11. How would you prefer to schedule public or shared transportation? Call or book online at least 24 hours in advance Call or book online on demand/as needed Arrive at a stop/station at posted times Custom plan a route from available options online OK Question Title * 12. Which zip code do you live in? OK Question Title * 13. Do you or would you use public or shared transportation for reasons other than medical appointments? (check all that apply) Shopping Work Entertainment outings No OK Question Title * 14. Are you eligible to receive SSI, Social Security Disability, MassHealth, SNAP, or other benefits with income guidelines? Yes No OK Question Title * 15. Do you speak English as a second language (ESL)? Yes No If yes, what language? OK Question Title * 16. I am: Male Female Non-Binary OK Question Title * 17. What is your race/ethnicity? African American/black American Indian/Alaska Native Asian Middle Eastern Caucasian/white Hispanic/white Hispanic/black Native Hawaiian/Pacific Islander OK Question Title * 18. Including yourself, how many people live in your household? Number of children under 18 Number of adults 18-64 Number of adults 65 and older OK Question Title * 19. What is your average annual household income? $0–$15,000 $15,001–$25,000 $25,001–$35,000 $35,001–$50,000 $50,000+ Don’t know No response OK Question Title * 20. Please list any suggestions to improve transportation services: OK DONE