Non Driver Post-Survey

Name


A red asterisk (*) indicates required questions.


  1. Which of the following statements best describes your experience with driving? (Mark only one).*
    I do not drive yet
    I am learning to drive
    I do not intend to drive in the next 3 years


  1. In your lifetime, how many crashes have you been in as a passenger?*
    0
    1
    2 or more


  1. In your lifetime, how many crashes have you been in where someone needed medical attention?*
    0
    1
    2 or more


  1. In the last 3 months, how many crashes have you been in as a passenger?*
    0
    1
    2 or more


  1. In the last 3 months, how many crashes have you been in where someone needed medical attention?*
    0
    1
    2 or more


  1. For the next series of questions, please mark how often each of the following statements is true for you in the last 3 months:
    I wear my seat belt when I am in the front seat.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I wear my seat belt when I am in the back seat.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have had a helpful conversation about driving safely.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have sought out useful information about driving safely.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I feel nervous about learning how to drive.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger where the driver appears very emotional or angry.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger while the driver talked on a cell phone.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger in a vehicle driven by a teen that has traveled more than 10miles per hour over the speed limit.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. While a passenger, I have been scared by an event while the vehicle was driven by a teen driver.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger in a vehicle where a teen driver will read texts while driving.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger in a vehicle where a teen driver's focus on driving gets distracted.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger in a vehicle when a teen driver received a ticket or a warning from police about their driving.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I have been a passenger in a vehicle where drivers honk at the teen driver in irritation or to warn them.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. I think I will be a better driver than my peers.*
    Never
    Seldom
    Neutral (Not Sure)
    Occasionally
    Often


  1. For the next series of questions, please mark how often each of the following statements is true for you in the last 3 months:
    Worn a seatbelt while I am in a motor vehicle (front or back seat). *
    Never
    Seldom
    Sometimes
    Often
    Always


  1. Been in a motor vehicle when the driver has been drinking or otherwise under the influence of drugs or chemicals.*
    Never
    Seldom
    Sometimes
    Often
    Always


  1. Been in a moving motor vehicle when the driver was using a cell phone.*
    Never
    Seldom
    Sometimes
    Often
    Always


  1. Been in a moving motor vehicle while the driver was texting.*
    Never
    Seldom
    Sometimes
    Often
    Always


  1. While a passenger, asked the driver to stop doing something I understood as unsafe (ex: on cell phone, texting, not wearing seatbelt, under the influence, being distracted).*
    Never
    Seldom
    Sometimes
    Often
    Always


  1. The local Project Ignition program's message is clear to me.*
    Strongly Disagree
    Disagree
    Neutral (Neither Agree or Disagree)
    Agree
    Strongly Agree


  1. The people involved in the Project Ignition program are generally respected in our school/community.
    Strongly Disagree
    Disagree
    Neutral (Neither Agree or Disagree)
    Agree
    Strongly Agree