CRASH/TRAFFIC REPORT
VOICE-CAPABLE on mobile devices. Cardinal News Public Safety Reporter not affiliated with any 911 center, police or fire agency. (* = REQUIRED)
Please agree #1) to call 911, if necessary, before proceeding with form, and #2) to NOT to use this form while driving a vehicle (Don't agree? Form won't submit).
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AGREE
WHAT IS THE ADDRESS OF THE CRASH: Address or Intersection (Don't worry, exact numeric addresses will not be published)
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Street Address or Intersection (both streets)
Suite, Apt or Business Name
City
State
Zip Code
Incident Date
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Month
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Day
Year
Date
Are you sure of the date?
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I'm SURE of the date.
I'm NOT sure of the date.
Time
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Hour
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Minutes
AM
PM
AM/PM Option
Are you sure of the time?
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The time is exact or near exact.
I'm sure within the hour.
I'm sure within 2 hours
I'm sure within 4 hours.
I'm not sure at all.
What was involved (check all that apply) ...
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Crash (don't know details)
Crash with injuries
One person trapped
Multiple people trapped
One person injured in crash
Multiple people injured in crash
Person struck by a vehicle
Multiple people struck by a vehicle
CPR administered at scene
Crash with injuries and hazard
Crash with hazard
Rollover crash on side
Rollover crash on roof
Car vs Pole
SUV vs Pole
Truck vs Pole
Car vs Car
Car vs SUV
SUV vs SUV
Car vs Truck
Car vs Pickup Truck
Pickup Truck vs Pickup Truck
SUV vs Truck
SUV vs Pickup Truck
Truck vs Truck
Crash, light damage
Crash, moderate damage
Crash, severe damage
Line down on vehicle
Crash into building
Large fire or flames
Small fire or flames
Black smoke
Gray smoke
Light smoke
Car fire
SUV fire
Pickup truck fire
Box truck fire
Semi-trailer truck fire (trailer)
Semi-trailer truck fire (cab)
Crash, property damage only
Crash Team Investigation (markers, etc)
News helicopter(s) overhead
ROAD CONDITIONS
Dry road conditions
Rain, wet pavement
Wet pavement
Snow, wet pavement
Snow accumulating on pavement
Black Ice
Ice on roadway, slippery
Roadway plowed
Roadway plowed and "salted"
Roadway "salted"
Other
How many ambulances on scene? (check one)
No ambulance on scene
1 ambulance on scene
2 ambulances on scene
3 ambulances on scene
4 or 5 ambulances on scene
More than 5 ambulances ...
Unknown
DETAILS ...
Police and Fire Agencies on Scene ...
(e.g., Chicago Police Department, Chicago Fire Department)
Please Add Details (describe what you saw/heard)
Describe any hazards and other details you noticed.
How do you know about incident? (check what applies)
I witnessed some or all of the above at the scene
I heard some or all of the above from another person
I heard on a police or fire scanner
Other
UPLOAD IMAGES OR VIDEO ...
Browse Files
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Yes? Enter name, otherwise type NO. If you leave this blank, photo(s) will be published WITHOUT credit.
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YES, with name above
YES, no credit if name blank above
NO
Cell Phone # (xxx-xxx-xxxx)
(OPTIONAL/WILL NOT BE PUBLISHED)
OK to Contact you?
YES, by cell text
YES, by email (below)
YES, by email or cell text
NO
Email
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