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Pike County Community Based Transportation Survey
The purpose of this survey is to improve transportation services, especially for getting people to and from work, appointments or shopping. All survey information is confidential.
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Indicates required field
1. Gender
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Male
Female
Other
2. What is your age?
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Less than 13
0-18
19-25
26-35
36-45
46-55
56-59
60-74
75+
3. Do you have a reliable source of transportation?
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Yes
No
If no, to the previous answer, how do you get to your destination?
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Walk
Ride a bicycle
Call public transportation
Drive own car
Borrow a car
Call a friend
Call a family member
Call a social service provider
Other
Check all that apply.
If other, please list:
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4. Places you need to go. Check all that apply.
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Doctor
Grocery
Court
Work
Visit friends and family
Shopping
PCDJFS
Drugstore
Chilld Care
Other
If other, please list:
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5. On what day(s) of the week is it hardest for you to get to work, appointments or other places you need to go? Check all that apply.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6. During what time(s) of the day is it hardest for you to get to and from work, appointments or other places you need to be? Check all that apply.
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Early Morning 5:00 A.M. - 8:30 A.M.
Late Morning 8:30 A.M. - Noon
Early Afternoon Noon - 3:00 P.M.
Late Afternoon 3:00 P.M. - 6:00 P.M.
Evening 6:00 P.M. - 9:00 P.M.
Late Night 9:00 P.M. and later
7. Are you aware Pike County has a public transportation system?
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Yes
No
Are you aware Pike County has more than one transportation option?
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Yes
No
8. Do you use public transportation?
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Yes
No
If no, why not?
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9. Do you have a disability?
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Yes
No
If yes, check all those that apply:
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Developmental/Learning
Psychiatric
Vision
Hearing
Other
If other, please list:
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10. Are you eligible to receive SSI, Social Security Disability, TANF or other benefits with income guidelines?
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Yes
No
11. How much are you willing to pay for a one-way ride to or from work, appointments or other places you need go? (Mark the maximum amount you would be willing to pay.)
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$1.00
$1.50
$2.00
$2.50
$3.00
More than $3.00
12. Please list any suggestions to improve transportation services in Pike County:
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Submit