Independent mobility you would choose, take this opportunity to share with us your unrealized goals. Though your transportation may be currently sufficient for your needs,and desires, your completion of this questionnaire is vitally important and very much appreciated.
We need your responses to support our effort to enhance the quality of living of visually impaired persons in the greater Omaha area. Using a dark lead pencil or pen, please place a check mark in the blank adjacent to the word which most appropriately describes your answer.
1. What is your present form of transportation:
( )cab
( )bus
( )car
( )friend/relative
( )Moby
( )other
2. Do you need transportation more than you are currently using?
( ) yes
( )no
( )sometimes
3. Indicate which of your transportation needs are currently not being met.
( )shopping -- grocery/ other
( )employment-job/interview
( )education
( )medical needs
( )recreation/entertainment
( )community events, religious events
( )
human and social service agencies,
4. How often do you use a taxi.
weekly:
( )1
( )3
( )5
( )more.
Monthly:
( )1
( )3
( )5
( )more.
5. What percentage of your monthly income do you spend on transportation:
( )10%
( )20%
( )30%
( )more.
6. If it were more affordable, how often would you use taxi service:
weekly
( )1
( )3
( )5
( )more.
Monthly
( )1
( )3
( )5
( )more
7. If a cab subsidy were available in our community, would you use it?
( )yes
( )no
8. If you are interested in further contact or correspondence regarding this please enter your name, address and telephone number below.
150 Surveys were distributed. 53 were returned at the time of tabulation.
September, 1989