1. Your name and contact information.2. Information about the crash.3. Police contact information and report number if applicable.4. Any injuries you suffered and subsequent medical treatment.5. Damage to the bicycle or other party.6. Names and contact information for witnesses and other involved parties.
When you submit the form, a confirmation message will be sent to you, and a notification message will be sent to BIKETOWN staff. The confirmation message will contain a link allowing you to edit your submission.
If you have any questions, or you would prefer to complete this form on paper, please contact firstname.lastname@example.org.