Quiet Supersonic Flights 2018 Community Test
Daily Response to Sonic Thumps
Daily Summary Response Form
To be formatted for administration by web and Smart Phone
Ability to “go back” provided in survey
[Self-administered questionnaire completed at the end of each day]
D1 Date: MM/DD/YY [Enable selectable format on survey]
Overall Daily Summary
D2 Did you hear any sonic thumps today?
1 Yes, [go to D3]
2 No, [go to D7]
D3 Over the course of your day, how much did the sonic thumps bother, disturb, or annoy you?
1 Not at all annoyed
2 Slightly annoyed
3 Moderately annoyed
4 Very annoyed
5 Extremely annoyed
D4 Did any sonic thumps startle you today?
1. Yes
2. No
Daily Summary near Home
D5 Select all time periods that you were at or near home today. Select all that apply.
8 -9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
Daily Summary near Work
D6 Select all time periods that you at or near work today.
8 -9
9-10
10-11
11-12
12-1
1-2
2-3
3-4
4-5
D7 Please enter any additional comments. [text box]
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Kathleen Hodgdon |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |