Pinellas is hosting a “Week of Remembrance” to honor the memory of the lives that have been tragically lost or forever impacted by roadway crashes throughout Pinellas County. These stories will serve as powerful reminders to help raise awareness for road safety. If you would like to share your story or your loved one’s story, please fill out the following form.

Stories may also be featured in promotional materials as we begin the effort to evaluate safety challenges countywide through our Safe Streets Pinellas program.

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* 1. Your Name

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* 3. Name of person(s) to be featured (this could include you or a loved one involved in a crash)

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* 4. Upload a photo of the person(s) to be featured. Please share a clear photo. We may use these materials online (social media, website) or in printed media.

PDF, DOC, DOCX, PNG, JPG, JPEG file types only.
Choose File

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* 5. Where did the crash happen? Please be as specific as you can. (E.g., at the intersection of US 19 and Drew St.)

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* 6. How were you or your loved travelling at the time of the accident?

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* 7. What were other circumstances of the crash? For example: did it include distracted driving, speeding, impairment, low visibility, or other circumstances.

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* 8. Please provide any other details you wish about your or your loved one's story. For example: what made them special or the impact of the crash on your and/or their family.

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* 9. What message would you like others to take away from this story?

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* 10. With which species do you most identify? (Please answer truthfully so we know to count your story as real)

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* 11. Do you consent for us to use this story publicly?

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* 12. Would you like to be contacted for future advocacy opportunities?

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