Mobility, Transport, and Disability in your City

1. A little about you

Thank you for taking part in this survey. This survey has 15 questions in total and should take approximately 10 minutes to complete. Please answer all questions concisely and in detail. Before beginning, please provide a bit of information on yourself.

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Who are you? (This question is for internal reference only.)

Name

Age

Gender

Do you have a physical disability?

Yes

If Yes, please list:

This is required

Do you have experience with or a connection to someone with a phyical disability?

Yes

If Yes, please describe:

This is required

Do you currently live full-time in your city?

Yes

* Please list the city / cities you reside in:

Required

This is required

1. A little about you

Who are you? (This question is for internal reference only.)

Do you have a physical disability?

Do you have experience with or a connection to someone with a phyical disability?

Do you currently live full-time in your city?

Which modes of transit do you currently use? (Please answer only for your current city / cities.)