Human Services Transportation Provider Survey
Your participation in this survey is greatly appreciated and will move the region one step closer to enhanced mobility for all!
What is the name of your organization? *
What is your address? *
What is your phone number? *
Who is the best contact for your organization? *
What is that contact's title?
1. Which of these best describes your organization?
Please select one.
2. Please identify the types of transportation limitations experienced by the people you serve:
Check all that apply.
3. What kind of transportation assistance does your agency offer?
4. What are the eligibility requirements or restrictions for accessing your transportation service?
Check all that apply.
5. If your transportation services are limited by trip type, please indicate which types of trips you provide:
6. Please describe your geographic service area:
7. How do your customers arrange to use your transportation service?
8. If advance reservations are required, how long in advance should a client call to arrange transportation?
9. What are the hours of operation for your transportation services?
Please include Mon-Fri, Sat, Sun and Holidays
10. What does your agency charge for transportation services?
Please include whether this is a fare/fee or donation and the cost. If there is no cost, please indiciate none.
11. What level of assistance is provided for riders?
12. What types of vehicles are used by your agency? List type (sedan, station wagon, minivan, standard 15-passenger van, converted 15-passenger van, light-duty bus, medium-duty bus, small school bus, large school bus, or other)
Please also include number of vehicles by type; whether leased, owned, or third party contracted; and whether vehicles have ADA accessibility.
12a. If your agency purchases transportation services from a third party, please list the partners here:
13. In the next 5 years, how many vehicles do you estimate that you may need for expansion or replacement?
Please include vehicle type (sedans, vans, buses, trucks/SUVs, other) and whether it is for expansion or replacement.
14. How many staff do you have dedicated to transportation service? List by Administrative, Operations, Drivers or Volunteers.
Please include number of full-time and part-time for each type of position.
15. How do you maintain your fleet?
16. What type of communication devices are used by your drivers?
17. For the most recent fiscal year for which you have statistics, please complete the following:
Number of individual passengers served (unduplicated)
Estimated number of trips for riders using wheelchairs
Estimated number of trips for seniors
18. How are your transportation services funded?
Check all that apply.
19. Do your customers routinely have transportation needs that you cannot serve?
Clear selection
If yes, please describe these needs:
20. Do you currently coordinate any aspects of your transportation services with other agencies or providers? (ex: pool insurance, joint training, share riders, etc.)
Clear selection
If yes, please describe the arrangement:
21. Based on your experience, what are the barriers to coordinating transportation services?
Check all that apply.
22. We would like to invte you to be involved in the Regional Mobility Center. Please indicate the level of intrerest your agency has in coordinating:
Check all that apply.
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