Passenger Safety Perception Assessment Form
Help us improve safety by sharing your travel experience and perceptions.
Full Name
*
First Name
Last Name
Email Address (optional)
example@example.com
Phone Number (optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Your Journey
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mode of Transport
*
Please Select
Bus
Train
Subway/Metro
Tram
Ferry/Boat
Taxi/Rideshare
Other
Please rate your agreement with the following statements about your recent journey:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I felt safe during my journey.
1
2
3
4
5
The vehicle was clean and well-maintained.
6
7
8
9
10
Staff or drivers were attentive to safety.
11
12
13
14
15
Emergency procedures were clearly communicated.
16
17
18
19
20
Security personnel were visible and approachable.
21
22
23
24
25
Lighting in stations/stops/vehicles was adequate.
26
27
28
29
30
How would you rate the overall safety of your journey?
*
1
2
3
4
5
Did you experience or witness any safety-related incidents during your journey?
*
Yes
No
If yes, please briefly describe the incident(s):
What could be improved to enhance passenger safety?
Submit Assessment
Should be Empty: