Individual Profile

This survey will provide you with personalized transportation choices based on your answers to the following questions. Your results will be more accurate and thorough if you are able to answer as many questions as possible. Your information will not be shared with anyone or any agency without your consent, however data gathered from this survey may be used to inform transportation resources in the future.

Basic

Do you have access to a smart phone? [+ What's this?]

Do you have access to the Internet?

Do you have access to a credit/debit card?

Do you have health insurance?

Age


Mobility Aids

Do you require any of the following (please select all that apply):

Ability

Please answer the following questions about your travel needs:

Are you able to ride a bicycle, even if you don’t own one?

Are you able to ride a Port Authority bus?

Can you ride in a vehicle that would require you to climb a few steps to get in?

Do you need assistance getting to the curb from whichever building you are leaving? (Home, doctor’s office, etc.)

Do you need assistance beyond the lobby of a public building or into a home?

Do you need assistance with packages/bags?

Do you need hand-to-hand service? [+ What's this?]

Do you need assistance securing your seatbelt?

Are you hearing impaired, or deaf?

Are you visually impaired, or blind?

Do you have any intellectual or behavioral health disabilities? [+ What's this?]

If you travel with a wheelchair, are you able to transfer from your wheelchair to the front seat of a car, independently?

Will you be traveling with another person?

Purpose of trip

Please indicate the trip purpose that you anticipate using the transportation services for (please select all that apply):

Time of trip

Please indicate the times of day and types of days that you anticipate using transportation service (please select all that apply):

Sort Preferences

Sort by: (Please select one of the following)