Driving Survey

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Driving Survey

Directions: Complete the Following choose the answer that best fits you.

Do you Text and Drive? *

Yes

Have you been in a car with a driver who texts and drives? *

Yes

When driving do you use a Cell Phone *

Yes

Yes bu t have a hand free device (Bluetooth)

Do you eat while driving *

Yes

Do you play with radio and/or ipod while driving *

Yes

Have you been in a car with a driver who plays with radio? *

Yes.

Do you wear a Seatbelt when in a car? *

Always

Often

Sometimes

Never

Do you follow posted speed limit or drive over posted speed limit? *

Always

Drive 5 over

Drive 10 over

Drive more than 10 over

7. Motor Vehicles crashes are the leading cause of death among American teenagers, killing between:

5000 and 6000 People

7000-8000 People

1000 People

None of the Above

Clear selection

Do you know the risks of not wearing a seatbelt: If not do you wear one? *

Yes

True/False- Motor vehicle crashes are the leading cause of death among American teenagers, killing between 5,000 and 6,000 teenagers every year. *

True

False

Do you think that laws regulating Teen Driving have decreased teen driving deaths? *

Yes

Option 3

What distracts you most? *

Using Phone

Talking to other people in car

Listening to Music

Submit

Clear form

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