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In an attempt to improve Road Safety we would like you to participate in our long term evaluation of drivers and passengers.

Please be honest and we guarantee any information will be treated in the strictest confidence and, if you have included it, no personal information will be disclosed. Thank You.
1.Contact Details
2.Age(Required.)
3.Gender(Required.)
4.Which one or more of the following applies to you?(Required.)
5.To not wear a seatbelt is:
(Required.)
6.I think it is serious to be in a Road Traffic Collision:

(Required.)
7.I would be happy to sit in a vehicle with the Driver using a mobile phone...(Required.)
8.I think its ok to send a text message whilst driving...(Required.)
9.People not involved in the actual crash are not affected in any way...(Required.)
10.I don’t care what other road users do…(Required.)
11.I would like to be a sensible driver / rider...(Required.)
12.I feel its ok for someone to have a couple of alcoholic drinks or take drugs then drive/ride...(Required.)