Horse Road Incident Report
Report to PEI Trail Riders any road-related near-miss, incident, accident or road rage involving a horse on Prince Edward Island.
What type of incident was this?
Motor vehicle incident
Cyclist incident
Dog attack
Other
Date and Time
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of incident (County)
Prince County
Queens County
Kings County
Location of incident (Address / road and nearest crossroad / landmark)
Your full name
*
Address
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
What is your involvement with the incident?
Rider/driver/handler of horse
Motorist
Cyclist
Witness
Police
Other
Your age on the date of the incident
Was the incident reported to police?
Yes
No
I don't know
Police report # (if applicable)
What type or road was this?
Main Highway
Secondary Highway/Road
Minor (paved) Road
Clay Road
City/Town/Village Street
Other
Speed limit were incident happened
50 km/hr
80 km/hr
90 km/hr
Construction/School Zone
Other
I don't know
What were the road/weather conditions at the time of the incident? (Check more than one if applicable)
Fine/Clear/Cloudy
Raining
Snowing
Foggy
Dry Road
Wet Road
Snowy Road
Icy Road
What was being done with the horse(s) at the time of the incident? (If more than one horse and activity, check all that apply)
Ridden
Driven
Led from ground
Led from horseback
Loose
What was the location of the horse(s) at time the incident occurred?
Road shoulder, traveling with traffic
Road shoulder, traveling against traffic
In right hand lane
More than one horse, on both sides of the road
Other
Did any of the following occur? (Check all that apply)
Motorist appeared to be exceeding the speed limit
Motorist was driving a non-street legal vehicle (eg ATV)
Motor vehicle passed too close to horse
Cyclist passed too close to horse
Driver or cyclist purposely startled horse (horn, engine rev, etc)
Motor vehicle collided with horse
Motor vehicle collided with horse-drawn vehicle
Cyclist collided with horse
Cyclist collided with horse-drawn vehicle
Road rage
Object was thrown
Rider fell
Horse fell
Loss of control of horse
Horse escaped handler/rider
Dog attack from unfenced yard
Dog attack from dog escaping handler
What was the injury to the horse(s)? (Check more than one if applicable)
None
Minor
Moderate
Severe
Fatal
Veterinary attention required
What was the injury to the handler(s)? (Check more than one if applicable)
None
Minor
Moderate
Severe
Fatal
Medical attention required
Was the handler using any of the following safety equipment? (Check all that are applicable)
Helmet
High-visibility vest
High-visibility quarter sheet
Back/body protector
Reflective slow vehicle sign
Light(s)
Describe the age and experience (i.e. approximate frequency of road travel) of the horse(s) involved.
Please describe any other pertinent details or events related to this incident.
Names and details of anyone else involved in this incident
If you are happy to let us pass your identifying details on to other organizations for the purposes of improving equestrian safety, please indicate by ticking this box.
Submit
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