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MOVE IT Survey Questionnaire

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Thank you for participating in this survey. We value your comments and opinions; we will utilize your responses to improve the MOVE IT program to help reduce traffic backup due to minor vehicle collisions. Please answer all six (6) questions.

1.How did you first know about the MOVE IT form?
Internet Surfing MVA Office VEIP Station
School/Driver's Ed Law Enforcement Officer Safety Patrol Personnel
Government Fairs/Events Other  

2.Have you carried or do you plan to carry a copy of the MOVE IT form in your vehicle?
Yes   No  

3.Are the instructions on the MOVE IT form easy to follow?
Yes   No   Somewhat  

4.Have you been involved in a property damage-only collision that you actually used the MOVE IT form?
Yes   No  

If you answered "Yes" to Question 4 above please complete the following questions before going to Question 5.
4a.Did you move your vehicle off the travel lanes?
Yes   No  

4b.Was the other party aware of the MOVE IT form?
Yes   No  

4c.Did the other party cooperate with you to provide their information?
Yes   No  

4d.How long did it take you to exchange information and clear the scene?
10 minutes or less   10 to 20 minutes   20 to 30 minutes   30 minutes or more  

4e.Did the exchanged information help you to process your insurance claim?
Yes   No   Somewhat  

5.Have you or will you let other people know about the MOVE IT form and web page?
Yes   No  

If you have informed other people of MOVE IT please indicate how many people: 

6.What is your overall rating of the MOVE IT program?
Very Good   Good   Fair   Poor   No Opinion