Pedestrian Hazard Report

The location of the pedestrian hazard you are report on is critical information in the City's pursuit to resolve the issue.

We have provided 3 boxes to help you better identify the location:

  • Nearest House Address
  • Nearest Intersection
  • Other Description of Location

Please enter information in at least one of these boxes.

 

*indicates a required field.

First Name *




Last Name *




Phone Number *




E-Mail *




Nearest House Address




Nearest intersection




Other description of location




Is the hazard inside or outside? *



Describe the location of the hazard *

   


Describe the obstacle or hazard *




Describe the surface type *

   


Describe the surface condition *

   


Describe the nature of the incident *

   


Describe who was involved in the incident *

   


Please enter the date and time of the incident *

Select a date from the calendar.  


Please describe what happened




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Is the hazard on a familiar walking route? *



Is this route frequently used by seniors or persons with disabilities? *



Were injuries sustained? *



Was medical attention required? *



If medical attention was required, where was it received?




Is this the first time you have reported this hazard? *