Form NHTSA Form 1626 NHTSA Form 1626 Post Experiment Questionnaire

OMB Control No. 2127-XXXX

Expiration Date XX/XX/XXXX

FMVSS ADS-DV Seat Preference (Study M)

Paperwork Reduction Act Statement: A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-XXXX. Completing this form is voluntary. The information collected on this form is being used for purposes of research on advanced vehicle technologies. We estimate that it will take 10 minutes to complete the questionnaire. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Room W45-205, Washington, DC, 20590.

Draft Post Experiment Questionnaire

Date: __________

Participant Number: __________

1. I felt safe riding in the driverless vehicle.

1b) Explain your response

2. I changed where I would sit in the driverless vehicle compared to where I would sit if riding with a human driver.

2b) Explain your response

3. I found the vehicle notifications to be helpful.

3b) Explain your response

4. The notifications were easy to understand.

4b) Explain your response

5. I would be less likely to wear a seatbelt in a driverless vehicle, compared to a vehicle with a human driver.

5b) Explain your response

6. Did the presence of a driver affect your choice of seat?

YES NO

Follow up with clarification about the response.

7. Did the presence of other passengers affect your choice of seat?

YES NO

Follow up with questions/comments

8. Do you think the orientation of the passenger seats affected your seat belt use?

` YES NO

Follow up with questions/comments

9. Do you think the orientation of the passenger seats affected your seat choice?

YES NO

Follow up with questions/comments

10. Do you think the vehicle notifications prompt you to wear your seatbelt?

YES NO

Follow up with questions/comments

11. Do you think the position of the touchscreen affect where you decided to sit?

YES NO

Follow up with questions/comments

12. Do you have any comments on the position of the touchscreen display (whether or not it affected your seat choice)?

13. Regarding the information presented on the touchscreen, can you provide any feedback on whether or not the information presented was easy to understand?

13a) Was there any information on the touchscreen display that was confusing in any way?

13b) Are there any other comments regarding the touchscreen display that you would like to share?

14. If you were to ride in a driverless vehicle like the ones you rode in today, which vehicle would you prefer to sit in?

A B

14a) Where would you choose to sit in your selected vehicle?

A B C D E (F)

14b) Please explain your response

15. Is there anything else about your experience with the driverless vehicle that you would like to share?

16. Were you aware of the researcher disguised as a participant during the study?

YES NO

NHTSA Form 1626