Please check all that apply.

Graph Answer # %
I am a cyclist only 1 20%
I am both a cyclist and a motorist 4 80%

What kind of cycling do you do on a regular basis? Select all that apply.

Graph Answer # %
Triathlon cycling on the road 3 60%
Road/Tri cycling on an indoor trainer 3 60%
Road cycling on the road 4 80%
Mountain biking/Adventure biking/Cyclocross off of the road 1 20%

Do you ever feel in danger while riding your bicycle on the road?

Graph Answer # %
Yes, all the time 1 20%
Yes, sometimes 4 80%

Have you ever been injured on the road while cycling?

Graph Answer # %
Yes 1 20%
No 4 80%
What is your name?
What is your email? (or parent's email)
Please check all that apply.
What kind of cycling do you do on a regular basis? Select all that apply.
Do you ever feel in danger while riding your bicycle on the road?
Have you ever been injured on the road while cycling?
Please describe the situation of your injury while cycling. If you have not been injured, please type NA.
Please answer this from the perspective of a motorist. What constructive ideas do you have to improve cycling safety in our area? If you are not a motorist, type NA
Please answer from the perspective of a cyclist. What ideas do you have on how to increase cycling safety in our area? If you are not a cyclist, type NA
What more do you want to share on this subject? Write anything you want to get off of your chest here.
Are you interested in the following? Check all that apply.
Would you like for us to contact you should we plan an in-person forum on this subject? We will get in touch with the email provided above.
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