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

ACORN Screening Tool

How often has lack of transportation
kept you from medical appointments,
meetings, work, or from getting things
needed for daily living?
Often
Sometimes
Never

Do you need assistance with
transportation for an upcoming
appointment?
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

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