Transportation needs survey All questions are required unless marked optional. Please do not include patient names, diagnoses, medical records, or exact addresses.
City or county 1. Which best describes you? Select an answer Patient Family member or caregiver Healthcare staff or case manager Transportation provider Veteran or veteran-serving organization Community member Other 2. In the past 3 months, how often have you experienced or helped someone with a healthcare transportation problem? Select an answer Never Once 2–3 times Monthly Weekly or more Not sure / not applicable 3. What was the most significant effect in the past 3 months? Select an answer No transportation-related disruption Delayed arrival Missed appointment Rescheduled appointment Delayed discharge or return home Extra staff or caregiver time Not sure / not applicable 4. How is healthcare transportation usually arranged? Select an answer Patient or family arranges it Phone calls, texts, or email Insurance or transportation broker Facility dispatch or scheduling software Public transit or community program Combination of methods Not sure / not applicable 5. About how much time does arranging one ride usually take? Select an answer Under 10 minutes 10–30 minutes 31–60 minutes More than 1 hour I do not arrange rides Not sure 6. Which challenges have you encountered?Select all that apply. Choose “none” or “not sure” on its own.
Finding an available provider Wheelchair or mobility support Cost or coverage Last-minute changes Recurring appointments Unclear confirmation or ride status Return-trip coordination Provider qualifications are hard to verify No challenges Not sure / not applicable
7. Which improvements would be most useful?Select all that apply. Choose “none” or “not sure” on its own.
One place to request transportation Providers with reviewed qualifications Clear confirmation and status updates Recurring ride scheduling Accessible transportation options Clear quotes and billing records Help coordinating return trips No additional tools needed Not sure
8. How likely would you be to explore a platform that coordinates requests with qualified transportation providers? Select an answer Very likely Somewhat likely Neutral / unsure Somewhat unlikely Very unlikely Not applicable What else should we understand? (Optional) Website
I understand AccessRide will store my answers for research and pilot planning and may use de-identified summaries. I have read the privacy notice . 
