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Hello:
You are invited to participate in our seat belt survey. In this survey, approximately twenty to thirty people will be asked to complete a survey that asks questions about seat belt usage. It will take approximately five to ten minutes to complete the questionnaire.
Your participation in this study is completely voluntary. If you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will remain confidential. Please darken the circle that corresponds with your answer and pick only one answer for each question. If you have questions at any time about the survey or the procedures, you may contact Michael Reilly at 908-689-6222. Thank you very much for you time and support.
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| What age group are you a member of? |
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| What is your education level? |
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| Do you travel in a passenger vehicle often? |
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| I wear my seat belt...... |
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| If you wear your seat belt is it mostly for which reason? |
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| If you do not wear your seat belt what is the main reason? |
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| Which of the following would increase your seat belt usage the most? |
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| Do you agree with the current seat belt law that requires both the driver and the front seat passenger to wear seat belts? |
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| Do you feel that the seat belt law should also apply to passengers in the rear seat? |
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| Do you feel that wearing a seat belt will harm you or help you if you are involved in a crash? |
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| If I were in a crash I would want to have my seat belt on. |
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| Have you ever been involved in a motor vehicle crash? If yes go to the next question. If no skip the next question. |
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| If you were involved in a crash, were you wearing a seat belt? |
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| Do you have any friends or family that have been involved in a motor vehicle crash? |
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| Do you feel that seat belts reduce injuries and fatalities? |
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| Do you feel the current $46.00 fine for not wearing your seat belt is appropriate? |
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| Would you raise, lower, or keep the $46.00 fine the same for not wearing your seat belt? |
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Hello:
You are invited to participate in our seat belt survey. In this survey, approximately twenty to thirty people will be asked to complete a survey that asks questions about seat belt usage. It will take approximately five to ten minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. Please darken the circle that corresponds with your answer and pick only one answer for each question. If you have questions at any time about the survey or the procedures, you may contact Michael Reilly at 908-689-6222.
Thank you very much for your time and support.
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