Have you been in a crash or near crash involving a bike in Newport, RI?

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* 1. Have you been in a crash or near crash involving a bike in Newport, RI?

What was the date or approximate date of the incident?

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* 2. What was the date or approximate date of the incident?

Location of the crash or near-crash

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* 3. Location of the crash or near-crash

Please check all of the following that apply:

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* 4. Please check all of the following that apply:

Please describe the incident to the best of your recollection. Please include time of day, road conditions, a description of the crash or near-crash, and any details you wish to share.

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* 5. Please describe the incident to the best of your recollection. Please include time of day, road conditions, a description of the crash or near-crash, and any details you wish to share.

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