New Voting Machines Questionnaire
Your voting experience is important. Please help us protect your vote by completing the short questionnaire below after you vote in Philadelphia's Municipal Election on November 5, 2019.

Your answers will be kept confidential unless you agree that we can share them.
For more information about this questionnaire: http://survey.povphilly.org
To fill out the questionnaire by phone, please call 212-473-6929.

Thank you, from Protect Our Vote Philly
povphilly@gmail.com • http://povphilly.org

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BASIC QUESTIONS
Ward and Division, or polling location
Time you arrived to vote (approximate)
Time
:
Was there a long line to check in to vote?
Clear selection
After check-in, was there a long line for the voting booth?
Clear selection
Were all of the machines in service?
Clear selection
If you didn't use a voting machine to vote, skip to GENERAL QUESTIONS
Did you have any difficulties making your selections on the touchscreen?
Clear selection
If you had difficulties with the touchscreen, what were they?
Did you use any accessibility features of the machine?
(such as: large text, accessibility console, audio ballot etc)
Clear selection
After you pressed Print Ballot, did you hear the printer?
(It makes a buzzing sound while printing)
Clear selection
Did you review your selections on the printout?
Clear selection
If you had any difficulty reviewing the printout, what made it difficult?
Did you need to press Spoil Ballot (to start voting over again)?
Clear selection
Did any other person enter the voting booth while you were voting, for any reason?
Clear selection
After you pressed Vote, did you hear the printer?
Clear selection
What did you like MOST about the voting machines?
What did you like LEAST about the voting machines?
GENERAL QUESTIONS about your overall voting experience
Did pollworkers give clear information and answer questions well?
Clear selection
Are you confident that your vote will be counted correctly?
Clear selection
If you are not very confident, why not?
Do you have any other comments about the new voting process or the new voting machines?
Did you take any photos or video that we should see?
Clear selection
Thank you for your time! If we can ask follow-up questions, please fill in your contact information:
Your name
Your phone number
Would you also be willing to talk to reporters about your experience?
Clear selection
A copy of your responses will be emailed to the address you provided.
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