Question Title

* 1. Age?

Question Title

* 2. Gender?

Question Title

* 4. How would you describe the lighting conditions when the incident occurred?

Question Title

* 5. At the time of the incident...

Question Title

* 6. How many motorists (cars, motorcycles, ATVs, etc.) were involved in your incident?

Question Title

* 7. Where were you when the incident occurred?

Question Title

* 8. 1.    Tell us more about where the incident occurred: What town were you in?

Question Title

* 9. What street were you on or next to?

Question Title

* 10. What intersection were you at?

Question Title

* 11. What trail were you on?

Question Title

* 12. What landmarks were nearby?

Question Title

* 13. Were you injured as a result of this pedestrian/bicycling incident?

Question Title

* 14. Did you report this incident to the police department or to the hospital?

Question Title

* 15. Were any animals involved in the incident?

0 of 15 answered
 

T