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JARC Coordination Plan - Oklahoma Department of Transportation

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Appendix C: <strong>Oklahoma</strong> <strong>Department</strong> <strong>of</strong> <strong>Transportation</strong>/United We Ride Providers Survey<br />

APPENDIX C: ODOT/UWR PROVIDERS SURVEY<br />

2011<strong>Transportation</strong> Survey<br />

The <strong>Oklahoma</strong> <strong>Department</strong> <strong>of</strong> <strong>Transportation</strong> (ODOT) and <strong>Oklahoma</strong> United We Ride are conducting a<br />

public transit/human service transportation survey to develop a comprehensive database <strong>of</strong> agencies that<br />

purchase and/or provide transportation services within the State <strong>of</strong> <strong>Oklahoma</strong>.<br />

The survey will also help to identify gaps and issues related to providing health and human service<br />

transportation and develop strategies for transportation providers to work together to create a more efficient<br />

and effective transportation system.<br />

Questions about the survey should be directed to Roger Eaton at ODOT by emailing reaton@odot.org or<br />

calling (405) 521-2584.<br />

1) Agency/Organization Information<br />

Name <strong>of</strong> Person Completing Survey:<br />

Agency/Organization Name:<br />

Address One:<br />

Address Two:<br />

City/Town:<br />

County:<br />

Zip:<br />

Phone Number (for follow-up):<br />

E-mail address (for follow-up):<br />

Date Survey Completed:<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

_________________________________<br />

2) Please indicate the types <strong>of</strong> transportation services your organization provides (either as an<br />

operator or a purchaser)? (check all that apply)<br />

On-demand/demand responsive<br />

Fixed route, fixed schedule<br />

Deviated (flexible) fixed route<br />

Subscription services (i.e. specific clients picked up on specific days)<br />

Other: ______________________ (specify)<br />

<strong>Oklahoma</strong> Locally Coordinated Public Transit C-1<br />

Human Service <strong>Transportation</strong> <strong>Plan</strong>

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