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Close Call Form

Hey there!
Have you had a close call with a bicycle, pedestrian or motorist?

Were you in a crosswalk (on foot, bike, skateboard) and a car almost hit you? Were you riding your bike on the right side of the road and a car almost hit you? Did you bike
through a red light and a car almost hit you?

Were you walking on the sidewalk and a bike almost hit you? Were you biking on the road and a pedestrian stepped out in front of you? Bike_Friendly_Platinum_2

Please let us know.

Please provide your phone and e-mail information so our bike/ped coordinator can contact you for more information if necessary. We will use your info only to contact you personally and will not share it.

* = Required Fields
Name:
Phone:
E-mail: *

Location of close call:

Other comments: