Passenger Survey - United Vision

Passenger Survey

Please complete this short survey to let us know how we're doing. Our goal is to provide our passengers with a safe and pleasant transport.

Passenger Survey

Passenger Name
Passenger Company
Passenger Email
Date/Time of Scheduled Transport
Order #
What type of vehicle did you ride in ?
1. Was the driver distracted by the use of a cell phone, radio or any other communications device?
 Yes    No
2. Were seat belts functional and in use by all passengers ?
 Yes    No
3. Was the driver late ?
 Yes    No
4. Did the driver travel off-route ?
 Yes    No
5. Did you recognize "Driver Fatigue" ?
 Yes    No
6. Did the driver demonstrate overall safe behaviors ?
 Yes    No
7. On a scale of 1-5 (with 5 being excellent) rate the driver's defensive driving skills.
Poor
 1  
 2  
 3  
 4  
 5
Excellent
8. Did you notice any hazards inside the vehicle?
 Yes    No
9. On a scale of 1-5 (with 5 being excellent) rate the vehicle's condition.
Poor
 1  
 2  
 3  
 4  
 5
Excellent
10. Do you have any complaints or additional comments ?