What type of report is this?
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I am reporting a crash I was involved in.
I am reporting a crash I witnessed.
I am reporting a near miss.
I am reporting harassment or assault that I experienced while bicycling.
Contact Information
First Name
Last Name
Email
Phone
Address
City
State
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District Of Columbia
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ZIP Code
How old are you?
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Under 18
18-25
26-35
36-45
46-55
56-65
Over 65
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Your gender
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Female
Male
Non-binary
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Prefer to self-describe:
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Gender Self Describe
Crash Details
When did the crash occur?
Where did the crash occur?
This information helps us identify dangerous locations. If possible, please enter a mappable address or intersection here.
Describe your experience in as much detail as you can.
Some details to include if possible:
What vehicles were involved?
Did you have any injuries?
Were there witnesses?
What were the weather and lighting conditions?
Tell us about the crash:
Check any of the situations below that describe your experience:
Right Hook
A driver makes a right turn from adjacent lane across the path of cyclist who is traveling straight
Left Hook
A driver makes a left turn across the path of a bicyclist who is traveling straight.
Dooring
A driver or passenger opens a vehicle door into the path of a bicyclist.
Passing
A driver strikes a bicyclist from behind or sideswipes the bicyclist while passing
U-Turn
A driver strikes a bicyclist while making a u-turn.
Harrassment or Assault
A driver intentionally distracts, intimates, harasses or assaults a bicyclist.
Was a for-hire vehicle involved in this crash?
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Yes
No
A for-hire vehicle is a taxicab, Uber, Lyft, Via, limousine, charter bus, or similar.
Police Response
Please check all that apply:
The police were called to the scene of the crash.
A police report was taken.
A statement from the bicyclist was included in the police report.
We would like to check in with you in the next few days to see how you're doing and share some resources. Is that okay?
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Yes
No