Self Reporting Survey - Blue Valley West final Question Title * 1. The last time you were in a motor vehicle, did you wear a seatbelt? Yes No Question Title * 2. 2. The last time you drove, did you text, talk on a phone, or were you otherwise distracted at any time? Yes No Question Title * 3. 3. Please list the ways you were distracted the last time you drove. (Select all that apply). Phone Texting Other (Eating, radio, GPS, etc.) I was not distracted at any time. Done