Attachment B-4: Transportation Services Consumer Survey | ADMINISTRATION-5600-MANUAL

Item #	Transportation Services Survey Questions	Answer Options
Please tell us how often these statements apply to your overall experiences with the provider’s Transportation Services.	Always Sometimes Never
1.	The drivers pick you up when they are supposed to.
2.	The drivers treat passengers with respect.
3.	The vehicles are comfortable.
4.	The vehicles are easy to get into and out of.
5.	We arrive at our destinations on time.
6.	I feel safe while riding in the transportation provider’s vehicles.
7.	How often would you be able to attend your Senior Center if transportation to and from the Senior Center was not available to you?
8.	Overall, how satisfied are you with the Transportation Services you receive to and from your Senior Center?	Satisfied Somewhat Satisfied Dissatisfied
9.	Who would you contact first if you had a problem with the Transportation Services?	Driver’s Supervisor or Agency Senior Center Site Manager Area Agency on Aging Division of Aging Services Do Not Know Others:
10.	In your opinion, how could we improve Transportation Services to you? Please mark all that apply.	Need to be able to go to more places Need better/newer vehicles or vehicles maintained better The drivers should provide more help into and out of the vehicle Reduce the length of my riding time
11.	Please tell us any other suggestions you have to improve the quality of the Transportation services you receive.	Comments:

Item #

Transportation Services Survey Questions

Answer Options

Please tell us how often these statements apply to your overall experiences with the provider’s Transportation Services.

Always
Sometimes
Never

The drivers pick you up when they are supposed to.

The drivers treat passengers with respect.

The vehicles are comfortable.

The vehicles are easy to get into and out of.

We arrive at our destinations on time.

I feel safe while riding in the transportation provider’s vehicles.

How often would you be able to attend your Senior Center if transportation to and from the Senior Center was not available to you?

Overall, how satisfied are you with the Transportation Services you receive to and from your Senior Center?

Satisfied
Somewhat Satisfied
Dissatisfied

Who would you contact first if you had a problem with the Transportation Services?

Driver’s Supervisor or Agency
Senior Center Site Manager
Area Agency on Aging
Division of Aging Services
Do Not Know
Others:

10.

In your opinion, how could we improve Transportation Services to you? Please mark all that apply.

Need to be able to go to more places
Need better/newer vehicles or vehicles maintained better
The drivers should provide more help into and out of the vehicle
Reduce the length of my riding time

11.

Please tell us any other suggestions you have to improve the quality of the Transportation services you receive.

Comments:

If the survey is to be administered by mail, please do not ask the consumer to identify him/herself, unless he or she wishes to be contacted for follow-up. Add lines at the end of the survey for the consumer to indicate voluntarily a desire for a contact and to provide his or her name and telephone contact information.