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Teen Safety Driving Survey
Name (optional): 


  1. What is your sex?
    male
    female


  1. What is your age?


  1. How many years of driving experience do you have?


  1. How often do you wear a safety belt when driving?
    Always
    Nearly Always
    Sometimes
    Seldom
    Never


  1. How often do you wear a safety belt when you are a passenger in a vehicle?
    Always
    Nearly Always
    Sometimes
    Seldom
    Never


  1. Do you take risks while driving?
    Yes
    No


  1. Do you consider driving with two or more passengers in your car a risk?
    Yes
    No


  1. Do you drive with two or more passengers in the car?
    Yes
    No


  1. Do you consider driving above the speed limit to be a risk?
    Yes
    No


  1. Do you ever drive above the speed limit?
    Yes
    No


  1. Do you consider adjusting the radio/CD player while driving a risk?
    Yes
    No


  1. Have you ever adjusted the radio/CD player while driving?
    Yes
    No


  1. Do you consider picking up something off the floor of your car while driving to be a risk?
    Yes
    No


  1. Have you ever picked up something off the floor while driving?
    Yes
    No


  1. Do you consider driving after drinking to be a risk?
    Yes
    No


  1. Have you ever drove after drinking?
    Yes
    No


  1. Do you consider talking on the cell phone while you drive to be a risk?
    Yes
    No


  1. Have you ever talked on the phone while driving?
    Yes
    No


  1. Do you consider eating while driving to be a risk?
    Yes
    No


  1. Have you ever ate food while driving?
    Yes
    No


  1. Do you consider driving when you are tired to be a risk?
    Yes
    No


  1. Have you ever drove when you were tired?
    Yes
    No


  1. Do you consider not wearing your seatbelt to be a risk?
    Yes
    No


  1. Did you know that traffic accidents are the leading cause of death for 15-19 year olds?
    Yes
    No