1. Default Section

 

* 1. What is your zip code?

* 2. Do you practice any of the following with your teen driver?

  Always Often Sometimes Rarely Never
Require seat belt use?
Restrict the number of passengers?
Warn about speeding?
Prohibit the use of cell phones while driving?
Limit nighttime driving?
Warn about drinking and driving?
Set your own rules over and above what is required by law?
Exhibit model behavior when your teen is the passenger in your vehicle?

* 3. I believe that the information in the "YOU Hold the Keys" brochure will influence me to become more involved with my teen driver during the:

  Strongly Agree Agree Neither Disagree Strongly Disagree
Learner’s Permit Stage
Provisional License Stage

* 4. Did you attend a parent orientation program at your teen’s driver education school?

* 5. How often does your teen drive?

* 6. Does your teen…

* 7. Does your teen…

* 8. What is your teen’s current phase of licensure?

* 9. What is your relationship to the teen driver in your household?

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