NOTE: This internet survey is only for display purposes and not a live survey.
Welcome
to the 2002 National Transportation Availability and Use Survey
This survey is a national survey of transportation use by the Bureau of Transportation
Statistics, U.S. Department of Transportation (see brochure). Your household
was chosen to answer some questions about its transportation use. The information
you provide will let those responsible for national transportation decisions
know what improvements are needed.
Your participation is voluntary, and your answers will be completely
confidential.
The study is authorized by
Title 49, Section 111(c)(2) of the United States Code, which permits agencies
to regularly measure customer satisfaction with their performance. The Office
of Management and Budget approved the collection of this information under OMB
number 2139-0007, which expires 4/30/2004.
Section C: Disability Information & Travel Outside the Home
I would like to ask you some questions about your travel and
transportation use.
C2. On average, about how many days per week do you leave the home
for any reason?
0
1 2
3 4
5 6
7
C3.
A focus of this survey is on transportation issues of
persons with disabilities. Do you have any of the following long lasting
conditions:
Yes
No
SKIP
a.
Blindness, deafness, or a severe vision or hearing
impairment?
b.
A condition that substantially limits one or more basic
physical activities such as walking, climbing stairs, reaching, lifting, or
carrying?
C4.
Because of a physical, mental or emotional condition
lasting six months or more, do you have any difficulty in doing
any of the following activities:
Yes
No
SKIP
a.
Learning, remembering or concentrating?
b.
Dressing, bathing, or getting around inside the home?
c.
Going outside the home alone to shop or visit a doctor's
office?
d.
Difficulty working at a job or business?
Yes
No
SKIP
C5.
Do you receive special education services?
Mild
Moderate
Severe
SKIP
C5a.
You told me that you have certain conditions or
difficulties. Overall, do you consider these conditions or difficulties to be
mild, moderate, or severe?
Vision
Hearing
Both
SKIP
C5b.
It is recorded that you have a vision or hearing
impairment. Does the condition affect your vision, hearing, or both?
Yes
No
SKIP
C6.
Do you need any specialized assistance or equipment to
travel outside the home?
C7. What kinds of specialized assistance or equipment? (Check all that
apply.)
Types
of Assistance:
Assistance from another person while inside the home
Assistance from another person while outside the home
Interpreter
Professional care such as rehabilitation or counseling
Service Animal
Types of equipment:
Manual wheelchair
Electric scooter or wheelchair
Cane, crutches or walker
Leg, arm, back brace
Prosthetic device (e.g., artificial arm, hand, leg, foot)
Automotive adaptive aid (e.g., hand controls)
Public transportation aid (e.g., wheelchair lift, kneeling bus, etc.)
Hearing aid
Magnifiers or high-powered glasses
Oxygen
Medication
Other (Specify: )
SKIP
Yes
No
SKIP
C8.
Do you have any difficulties in getting the transportation
that you need?
C9. What kinds of difficulties do you have in getting the transportation
that you need? (Check all that apply.)
Transportation
Related:
Don't have a car
No or limited public transportation in community
No or limited taxi service in community
Buses don't run on time
Buses don't run when needed
Bus stops are too far away
Transportation does not accommodate special equipment (e.g., walker, cane,
wheelchair)
Disability Related:
Physical or other disability makes transportation hard to use
Other:
Costs too much
Don't want to ask others for help or inconvenience others
There's no one I can depend on
Fear of crime stops me from going places
Other (Specify: )
SKIP
