Transportation Needs Questionnaire
For Residents of Waverly, Iowa
The City of Waverly, the Waverly Development Group, Regional Transit Commission (RTC) and the Wartburg College Social Work program are working together to identify ways of improving transportation options for Waverly residents. Please tell us your needs and expectations related to current and potential local transportation services, even if all people in your household presently drive and have never used a transportation service.
Your input is important to us. Please return the questionnaire to the box in the Waverly Manor’s mailroom by November 1, 2006. Please respond based on your present circumstances.
There is no obligation to participate in this questionnaire, but your ideas and information are helpful to us as we explore transportation service options for the Waverly area. All identifying information will be kept confidential. All data will be destroyed at the conclusion of the research project December 13th 2006. Completion of this survey indicates your agreement to participate in this project. If you have any questions, concerns or if you would like more information about this questionnaire, please contact Dr. Tammy Faux, 352-8239 or Kara Aanenson, 352-7937. Thank you!
Before you begin, please tell us if you are answering the survey for someone who is unable to complete the survey for themselves. ____no ____yes
1. How old are you and the other members of your household? (Please check the space that best describes you and write the number of people in each category for the rest of your household)
YouOthers
0-15 years of age______
16-35 years of age______
36-59 years of age______
60-69 years of age______
70-79 years of age ______
80+ years of age______
2. Do you have a caregiver?
____no ____yes
3. What is your primary means of transportation? (Please check all that apply.)
____Personal automobile ____Friend, relative, caregiver or neighbor
____ Volunteer driver ____ “RTC” van/bus service/Senior center van
____ Private van service ____ Medicaid transportation
____ Other ______
4. If you don’t have transportation, why not? (Please check all that apply.)
____ Can’t drive due to a medical/physical condition
____ Can’t afford a car
____ Can’t afford gas/insurance
____ No need, everything I need I can access without a car
____ Other ______
5. Are you aware that the RTC bus is open to the general public with a 24 hour advance request?
____no ____yes
6. Do you ride the bus or RTC? ___ no ___ yes
7. If you do not use the bus or RTC regularly, why not? (Please check all that apply.)
____ No service where I am or where I want to go ____ I can’t afford it
____ Poor connections or transfers____ I don’t know about it
____ Limited hours of operation ____ I don’t feel safe
____ I don’t know how to ride the bus ____ I don’t need it
____ Other ______
8. What times would you MOST want to use the transportation service? (Please check all that apply.)
____ 6 am to 9 am ____ 4 pm to 7 pm
____ 9 am to 12 noon ____ 7 pm to 10 pm
____ 12 noon to 4 pm ____ 10 pm to 6 am
9. What days of the week would you be most likely to travel locally using a transportation service (such as a cab or bus)? (Please check all that apply)
____ Monday ____ Tuesday ____ Wednesday ____ Thursday
____ Friday ____ Saturday ____ Sunday
10. Do you need any of the following kinds of assistance when you travel locally? (Please check all that apply)
____ Assistance getting into and out of a vehicle
____ Escort to accompany you
____ Help loading and unloading packages
____ Door-to-door service
____ Wheelchair, lift or ramp
____ Space for a fold-up wheelchair
____ Other______
11. How important would each of the following characteristics be in your decision to use a transportation service (such as a cab or bus)? (Please circle the number that most applies)
Not importantVery important
Service from home to work 12345
Flexibility of ride times 12345
Evening service12345
Late-night service12345
Weekend service12345
Guaranteed ride home12345
Number of stops12345
Clear fare structure12345
Easy to arrange12345
Same day scheduling12345
Wheelchair accessible12345
Other ______
12. In an average week, how many vehicle trips do you take? (include a round trip as two trips)
____ None ____ 11-15
____ 1-5____ 16-20
____ 6 – 10____ More than 20
13. If you had additional transportation options, how many MORE trips would you take per week?
____ None ____ 11-15
____ 1-5____ 16-20
____ 6 – 10____ More than 20
14. What is your yearly income?
____ $0 - $10,000
____ $11,000 - $20,000
____ $21,000- $30,000
____ $31,000+
- How much would you pay a transportation service (each way)?
____ $0
____ Less than $3.00
____ $3.00 - $5.00
____ $5.01 - $7.00
____ More than $7.00
____ Other ______
16. Do you think there is community support for a transportation service?
____no ____yes
Please explain:
17. Would you support an increase in sales or property taxes to support a coordinated transportation system in the Waverly area?
____no ____yes
Please explain:
18. Please add additional comments you may have about public transportation in the Waverly area.
May we contact you regarding this questionnaire? ____no ____yes
If yes, add your contact information:
Name:______
Address:______
Phone number:______
Email Address:______
Thank you for your assistance!
Over