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2. 
4. Freedom Express 2021 Survey
   The Family and Community Support Services (FCSS) department within the Town of Hinton offers accessible transportation services for Hinton/Yellowhead County residents with short-term or long-term physical or cognitive impairment through the Freedom Express.
6. Are you a Freedom Express client?*

   1. Yes
   2. No
8. Have you used Freedom Express services within the past six months?*

   1. Yes
   2. No
10. What do you use Freedom Express for?*

    1. Medical appointments
    2. Shopping appointments
    3. Both
    4. Neither
12. Does the Freedom Express meet your needs for transportation?*

    1. Yes
    2. No
    3. Sometimes
14. If Freedom Express services do not meet your needs, please explain why:
16. Are you able to book appointments for the days/times you need with Freedom Express?*

    1. Yes
    2. No
    3. Sometimes
18. Are you happy with the services you receive from Freedom Express?*

    1. Yes
    2. No
    3. Sometimes
20. Do you use Freedom Express because it is your only option for transportation?*

    1. Yes
    2. No
    3. Sometimes
22. Do you have any additional feedback you would like to share?
24. THANK YOU FOR THE FEEDBACK!
    Would you like to enter to win a $50 gift card? If so, please add your name and phone number below:
26. Name
27. Phone Number
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

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