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Mock Crash Survey

Fallston High School (Mock Crash Survey) 2026
Date
Driver’s License Status

In the last 30 days have you:

Impaired
Very OftenOftenNot OftenNever
Consumed alcohol or used cannabis within 4 hours of driving?
Very Often
Often
Not Often
Never
Ridden in another young driver’s vehicle after they had consumed alcohol or cannabis in the previous 4 hours?
Very Often
Often
Not Often
Never
Occupant Protection
Very OftenOftenNot OftenNever
Driven/ridden as a passenger in any seating position without wearing a seat belt?
Very Often
Often
Not Often
Never
Operated a vehicle with unbuckled passengers?
Very Often
Often
Not Often
Never
Requested that someone else in a vehicle buckle up?
Very Often
Often
Not Often
Never
Fatigue
Very OftenOftenNot OftenNever
Driven while so tired that you had a hard time keeping your eyes open?
Very Often
Often
Not Often
Never
Asked for someone else to drive as you didn’t feel up to it due to stress, tiredness, or disinterest
Very Often
Often
Not Often
Never
Drove because you had to – even though you didn’t feel you were up to it mentally or physically
Very Often
Often
Not Often
Never
Distracted
Very OftenOftenNot OftenNever
Read or typed a message (through any platform) or e-mail while operating a moving vehicle?
Very Often
Often
Not Often
Never
Used a social media app while operating a moving vehicle?
Very Often
Often
Not Often
Never
Drove out of your lane onto the shoulder or grass due to inattention
Very Often
Often
Not Often
Never
Talked on a cell phone without a hands-free device used while operating a moving vehicle?
Very Often
Often
Not Often
Never
Distracted someone from being able to pay full time and attention while they were operating a moving vehicle?
Very Often
Often
Not Often
Never
Forgot to slow down and/or move over as required in a work zone?
Very Often
Often
Not Often
Never
Drove poorly as a result of being irritated or upset by something else that had occurred during my day?
Very Often
Often
Not Often
Never
General
Very OftenOftenNot OftenNever
Felt proud of yourself after handling a challenging drive?
Very Often
Often
Not Often
Never
Ridden in another driver’s vehicle and felt their driving was unsafe?
Very Often
Often
Not Often
Never
Driven 20 MPH or more over the posted speed limit?
Very Often
Often
Not Often
Never
Had to deal with driving in poor weather conditions you were unprepared for?
Very Often
Often
Not Often
Never
Asked another driver to change how they were driving due to feeling unsafe?
Very Often
Often
Not Often
Never
Driven and ignored a vehicle dashboard warning light or a maintenance issue that should have been addressed?
Very Often
Often
Not Often
Never
Did not know how to manage your vehicle’s roadway positioning when emergency responders were approaching?
Very Often
Often
Not Often
Never
Had an emergency alert notification show up on your phone or vehicle infotainment system about an approaching emergency vehicle, disabled vehicle or other emergency ahead.
Very Often
Often
Not Often
Never