Exit this survey Generic 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. Question Title 1. Contact Details Name: Address 1: Address 2: Town: Postal Code: Email Address: Phone Number: Question Title 2. Age Question Title 3. Gender Male Female Question Title 4. Which one or more of the following applies to you? Driver Rider Passenger Question Title 5. To not wear a seatbelt is: Very dangerous Dangerous A little bit dangerous Not dangerous at all Question Title 6. I think it is serious to be in a Road Traffic Collision: Very serious Quite serious Serious No not really Question Title 7. I would be happy to sit in a vehicle with the Driver using a mobile phone... Disagree completely Disagree a bit Agree Agree very much Question Title 8. I think its ok to send a text message whilst driving... Completely disagree Disagree Agree a bit Agree a lot Question Title 9. People not involved in the actual crash are not affected in any way... Completely disagree because other people are affected such as families Disagree because the emergency services also attend Agree a bit because passers by could get hurt Agree a lot because it only affects the people in the vehicles Question Title 10. I don’t care what other road users do… Disagree a lot because I do care very much Disagree a bit Agree a bit Agree a lot, I don’t care at all Question Title 11. I would like to be a sensible driver / rider... Agree a lot Agree a bit Disagree Disagree a lot Question Title 12. I feel its ok for someone to have a couple of alcoholic drinks or take drugs then drive/ride... Disagree a lot Disagree a bit Agree a bit Agree a lot Next
