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Survey Name Driving
Description Driving
Category    (Browse All Categories)

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Howdy!

Thanks for participating in our survey. We are researching car improvements for accident prevention. In participating in this survey, you will be entered into a drawing for a $500 prize! Please answer the questions as best you can, we tried to make them really straightforward. The whole survey should take about 5-10 minutes. Thanks again!
 
   

Have you ever been in a car accident?
Yes  No  
 
   

How many accidents have you been in?
1
2
3
4
5+
 
   

Rear-End Broadside Sideswipe Head-On Pedestrian Collision
What types of accidents have you been in?
 
   

Are there any special details to any accident? (Optional)
 
 
   
Enter answer with no spaces, commas or periods or dollar signs.
What was the total amount of damages in the accidents? (Estimate is fine)
 
 
   

Was anyone injured?
Yes  No  
 
   

Did your insurance go up?
Yes  No  
 
   

How much did your insurance go up? (Estimate is fine)
 
 
   

Does your vehicle have any on-board Situational Aides (i.e. Smart Cruise Control, Lane Drift Detector, etc) ?
Yes  No  
 
   

Your accident could have been avoided if you were paying better attention or your reaction time had been faster.
 
   
We will NEVER solicit, sell or use your information for any purpose other than this survey.
What is your name?
 
Email address?
 
Telephone number?
 
 


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