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ADA Interviews

Name:
Date of Interview
Mobility Devices used
What type of disability does the individual have?
Alzheimers
Cognitive
Developmental
Dementia
Hearing Impaired
Mentally Challenged
Physically Challenged
Temporary
Visually Impaired
Preferred Media/Communication Type
Do you use the regular Omnitrans buses now?
If no or sometimes, what limits or prevents you from riding the buses? (E.g., no sidewalks)
What is the most difficult part of riding the bus for you?
Does anything limit you or prevent you from getting to the bus stop by yourself?
Does anything limit you or prevent you from boarding the bus by yourself?
Have you ever received any training to use the fixed-route bus service?
Yes
No
If not, would you be interested in participating in the free training?
Yes
No
N/A
How do you currently travel?
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