University of San Francisco California
Transportation Questions
AAFP Social Needs Screening Tool
Do you put off or neglect going to the doctor because of distance or transportation?
Yes/No
Accountable Health Communities Health-Related Social Needs Screening Tool
In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?
Yes/ No
Arlington Screening Tool
Within the past 12 months, has lack of transportation kept you from medical appointments, getting your medicines, non-medical meetings or appointments, work, or from getting things that you need?
Yes/ No
Boston Medical Center-Thrive Screening Tool
Do you have trouble getting transportation to medical appointments?
Yes/ No
HealthBegins Upstream Risk Screening Tool
How often is it difficult to get transportation to or from your medical or follow-up appointments?
Does not apply
Never
Sometimes
Often
Always
Health Leads Social Needs Screening Toolkit
In the last 12 months, have you ever had to go without health care because you didn’t have a way to get there?
Yes/No
North Carolina Medicaid Screening Tool
Within the past 12 months, has a lack of transportation kept you from medical appointments or from doing things needed for daily living?
Yes/ No
PRAPARE
Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? Check all that apply.
Yes, it has kept me from medical appointments or from getting my medications
Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need
No
I choose not to answer this question
WellRx Toolkit
Do you have trouble finding or paying for a ride?
Kaiser Permanente's Your Current Life Situation Survey
In the past 3 months, did you have trouble paying for any of the following? (Select ALL that apply)
Transportation
Has lack of transportation kept you from medical appointments or from doing things needed for daily living? (Select ALL that apply)
Kept me from medical appointments or from getting medications
Kept me from doing things needed for daily living
Not a problem for me