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Driving Behavior Survey- Self-Report Form.

Screening Visit

Screening

Submitted by Lab on Sun, 03/17/2013 - 14:58

Instructions: For each item below, please select the number next to each item that represents how frequently you believe that you use each driving skill during your typical driving performance.
1 being not at all or rarely; 2 being sometimes, 3 being often and 4 being very often.

Prior to starting the car, I check all mirrors, adjust the seer (when necessary) and put on the seat belt. *

When moving in traffic, I check oncoming traffic, wait my turn, and accelerate properly. *

I use directional (turn) signals prior to making a turn or changing lanes. *

I turn around and check directly through the windshield for any obstacles or people in my way before backing up. *

I look directly through the left or right passenger side windows to check my "blind" spots before changing lanes. *

I drive at a rate of speed that is within the speed limits. *

I drive within the marked lane o a highway, and stay on my side of the road on two-lane roads. *

I avoid driving in the breakdown lanes or on road shoulders unnecessarily. *

I yield the right of way to other drivers at intersections and traffic rotaries. *

I react quickly and properly to brake lights when activated on vehicles ahead. *

I watch ahead of cars in front of me for obstacles that may be in the road. *

I observe and respond appropriately to traffic signals (e.g. slow at yellow, stop at red). *

I adjust speed to bad weather conditions affecting traffic and the roadway. *

I drive at an appropriate distance from vehicles ahead of me (at least one car length for each 10 miles per hour of speed). *

I brake smoothly to stop at marked intersections as required. *

I maintain two hands on the steering wheel while driving. *

I drive slowly at an appropriate speed when backing up (in reverse gear). *

I notice and obey posted traffic signs (stop, yield, school zones, merge, etc). *

I follow posted route markers (I do not get lost while driving). *

When parking, I slow to a safe speed and park within the designated space. *

I maintain attention (eye contact) toward traffic and the road ahead of me while driving. *

I keep the volume of the car radio, tape player, or CD player at low enough levels that I can hear sirens or other cars' horns. *

I make sure that the passengers riding with me wear their seat belts. *

I refer to maps before driving through a new area or city. *

I slow down and move away from maintenance crews working on or near the roadway. *

Before entering any intersection, I check approaching traffic for safe entry. *

Please select the number that best describes you're overall driving performance (One being poor and ten being excellent): *

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Driving Behavior Survey- Self-Report Form.

Screening Visit