Please complete page for the entire walkable area on your survey map.
Day of week: _______________ Time observation began: ________ a.m. / p.m.
Date: _____________________ Time observation ended: ________ a.m. / p.m.
Directions: Place a checkmark below next to any items that are a problem for walkers and note:
- What might especially be a problem for a child, senior or person with disabilities?
- Note landmarks, streets or sides of streets (north, south, east or west) on the blank line to the right of each item you check.
Problems for walkers / Location
☐ Need shade trees ___________________________
☐ Need grass, flowers, landscaping ___________________________
☐ Need benches and places to rest ___________________________
☐ Grass/landscaping needs maintenance ___________________________
☐ Need water fountains and bathrooms ___________________________
☐ Need sidewalk leading to bus stop ___________________________
☐ Bus stop doesn’t have shelter ___________________________
☐ Bus stop doesn’t have adequate lighting ___________________________
☐ There is graffiti or vacant/run-down buildings ___________________________
☐ There is trash on the route ___________________________
☐ Other (please specify) ___________________________________________
Overall rating of comfort/appeal in walk survey area:
☐ Excellent ☐ Good ☐ Fair ☐ Poor