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Questionnaires for Drivers

A. Demographic Information

 

Instruction: Please fill in the blanks with the specific answers.

 

 

Name:  _______________________       Civil Status:  ____________________

 

Address:  _______________________________________________________  

 

Occupation:  _______________________     Sex: ______      Age: __________

 

 

B. Perception of the Respondents

Instruction: Please indicate your answer on the blank or encircle your answer on some questions that have choices.

1.         How long do you have your cellphone?

            2 months ______

            3 months ______

            4 months and above ______

            1 year ______

            More than a year ______

2.         Do you use cellphones while driving your vehicles? __________________________________________________________

3.         How often do use your cellphone while driving?

1 (Very Frequent)      2 (Frequent)     3 (Average) 4 (Rare)          5(Very Rare)

4.         Are you aware that it is dangerous to use cellphone while driving?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

5.         What are the reasons you use cellphone for, even though you are driving (you can check more than 1)

            Emergency __________

            Concern for the caller _________

            Personal interest ________

            Call from family members ________

            For business purpose ________

            Others, please specify: __________________________________

6.         Do you feel uncomfortable using mobile phones while driving?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

7.         Is it rewarding using mobile phones while driving in a sense that it fulfils objectives of some sort?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

8.         Are you distracted when your mobile phone rings while you are driving?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

9.         What hand do you use when you pick up your phone while driving?

Left __________      Right __________

10.       Do you have difficulty steering the wheel with your other hand while you pick up the mobile phone with the other?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

11.       Do you take your eye of the road when you pick up the mobile phone?

1 (Very Frequent)      2 (Frequent)     3 (Average) 4 (Rare)          5(Very Rare)

12.       Do you experience missing a signal in the stoplight because of answering a ringing phone or dialling a number to the phone?

1 (Very Frequent)      2 (Frequent)     3 (Average) 4 (Rare)          5(Very Rare)

13.       When dialling a phone while driving, do you take your eye off the road?

1 (Very Frequent)      2 (Frequent)     3 (Average) 4 (Rare)          5(Very Rare)

14.       Are you aware that it is a crime to use mobile phone while driving?

1 (Definitely)              2 (Yes)            3 (Undecided)           4 (No)             5 (Never)

15.       Have you been in a minor or major accident, or just an error in driving because of using mobile phone? If yes, please elaborate your experience on the blank below.

________________________________________________________________________________________________________________________________

16.       Do you believe that using mobile phone while driving is dangerous? Please share your opinion about the matter.

________________________________________________________________________________________________________________________________________________________________________________________________

17.       What are the other disadvantages of using mobile phones while driving based on your experiences as a driver?

________________________________________________________________________________________________________________________________________________________________________________________________

-Thank you for your cooperation! -


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