Safe Neighborhood Streets Survey Question Title * 1. Please provide your name and contact information so we can forward a summary of the results of this survey to you. Your individual answer will be kept anonymous. Everyone in your household is welcome to complete the survey. Name Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 2. How would you rate the safety of your neighborhood street with regard to traffic? Very Safe Somewhat Safe Moderately Safe Somewhat Unsafe Very Unsafe Question Title * 3. Do you feel cut-thru traffic on your street is excessive? Yes No Other (please specify) Question Title * 4. What is the current posted speed limit on your street? Question Title * 5. If your street lacks a posted speed limit or it is 30 mph or greater then would you be in favor of setting the speed limit at: 15 mph 20 mph 25 mph Other (please specify) Question Title * 6. Which of the following safety measures would you prefer? Click of each of the following for an illustration. Bike-pedestrian lanes Raised pedetrian crossings Speed humps Curb bump-outs at crossings Other (please specify) Question Title * 7. Would you walk or bike more on your street if these safety measures were added? Yes No Uncertain Question Title * 8. Is there anything else you'd like to share about traffic conditions on your neighborhood street? Done
