Personal Safety

1. When you rode a motorcycle during the past 12 months, how often did you wear a helmet?
   I did not ride a motorcycle during the past 12 months
   Never wore a helmet
   Rarely wore a helmet
   Sometimes wore a helmet
   Most of the time wore a helmet
   Always wore a helmet
   
2. When you rode a bicycle during the past 12 months, how often did you wear a helmet?
   I did not ride a bicycle during the past 12 months
   Never wore a helmet
   Rarely wore a helmet
   Sometimes wore a helmet
   Most of the time wore a helmet
   Always wore a helmet
   
3. How often do you wear a seatbelt when riding in a car driven by someone else?
   Never
   Rarely
   Sometimes
   Most of the time
   Always
   
4. During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol?
   0 times
   1 time
   2 or 3 times
   4 or 5 times
   6 or more times
   
5. During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?
   0 times
   1 time
   2 or 3 times
   4 or 5 times
   6 or more times
   

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Questions provided by the Centers for Disease Control.
Copyright © 1999 University of Colorado Health Sciences Center. All rights reserved.