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357 A p p e n d i x W Driving History Questionnaire
358 DRIVING HISTORY A note on privacy This survey is anonymous. The record kept of your survey responses does not contain any identifying information about you unless a specific question in the survey has asked for this. If you have responded to a survey that used an identifying token to allow you to access the survey, you can rest assured that the identifying token is not kept with your responses. It is managed in a separate database, and will only be updated to indicate that you have (or haven't) completed this survey. There is no way of matching identification tokens with survey responses in this survey. There are 16 questions in this survey DH 1 1 Over the past five years, what is your average annual mileage (estimate)? Please choose only one of the following: less than 5,000 miles 5,000 - 10,000 miles 10,000 - 15,000 miles 15,000 - 20,000 miles 20,000 - 25,000 miles 25,000 - 30,000 miles more than 30,000 miles 2 How many years have you been driving? Please write your answer here: 3 Describe the kind(s) of driver training that you have received prior to getting a license as well as throughout your driving experience. Please choose all that apply:
359 Informal driver training offered by a parent, family member or friend Driver's Education offered through school Driver's Education offered through private company Operated farm equipment or lawn tractors Motor sports experience Post-licensure driver skills training/enhancement Other: 4 In the past year, how many moving or traffic violations have you had? Please choose only one of the following: 0 1 2 3 4 5 more than 5 5 What type of violations were involved? Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '4 [4a]' (In the past year, how many moving or traffic violations have you had?) Please write your answer here:
360 6 In the past year, how many crashes have you been in? Please choose only one of the following: 0 1 2 3 4 5 more than 5 7 Accident 1 Severity (select highest or most severe option applicable) Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Injury Tow-away (any vehicle) Police-reported Damage (any), but no police report 8 Were you at fault? Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Yes No
361 9 Accident 2 Severity (select highest or most severe option applicable) Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Injury Tow-away (any vehicle) Police-reported Damage (any), but no police report 10 Were you at fault? Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Yes No 11 Accident 3 Severity (select highest or most severe option applicable) Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Injury Tow-away (any vehicle) Police-reported Damage (any), but no police report 12 Were you at fault?
362 Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Yes No 13 Accident 4 Severity (select highest or most severe option applicable) Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Injury Tow-away (any vehicle) Police-reported Damage (any), but no police report 14 Were you at fault? Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Yes No 15 Accident 5 Severity (select highest or most severe option applicable) Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following:
363 Injury Tow-away (any vehicle) Police-reported Damage (any), but no police report 16 Were you at fault? Only answer this question if the following conditions are met: ° Answer was greater than or equal to 'more than 5' at question '6 [5]' (In the past year, how many crashes have you been in?) Please choose only one of the following: Yes No Submit your survey. Thank you for completing this survey.
