Near Miss & Crash Reporter

Report your incident

Use Bicycle Network’s crash reporter to report the details about your incident including when, where and how it happened, if you were injured and other information.

Even if you didn’t crash but had a near miss it is still good to report it so we can work on the things that are causing problems for people who ride.

Reporting your crash will help us discover the most common causes of incidents so that we can work to get them fixed.

If you are a Bicycle Network member and need to make a claim, please call 1800 639 634 to book an appointment with our Riders’ Rights team.

Bicycle Network

Ph 03 8376 8888
bicyclenetwork.com.au

Protecting your privacy
We collect, use, disclose and otherwise handle your personal information in accordance with the terms of our Privacy Policy Statement. All information remains the property of Bicycle Network.

We do not collect personally identifiable information about you except where you specifically provide this information on a voluntary basis. We will make every effort to ensure that whatever information you provide will be maintained in a secure environment.

Tell us about your incident

What date did the incident occur?

What was the approximate time of the incident?

Hour

Minute

Where did the incident occur?

Street Address

City/State

Postcode

How far from home were you when the incident happened?

0 to 3 km3 km to 5 km5 km or 10 km10 km or more

What is your home post code?

About the location

Other

Which of the following best describes the intersection?

4-WAY INTERSECTIONT-INTERSECTIONROUND-A-BOUT

Other Details

Other details

Did this contribute to the incident? Please select one answer per row

	Yes	No	Not Sure
Pot holes
Cracks that run in the same direction of travel
Cracks across the direction of travel
Bumps in the surface
Rough surface
Loose stones
Green bike lane paint
Painted lines and symbols
Icy surface
Wet surface
Muddy surface
Oil/petrol
Leaves, branches or other vegetation
Tram/train tracks

What happened?

Which of the following best describes the type of incident?

Near-miss with a motor vehicleCollision with a motor vehicle (car, motorbike, truck, car door, stationary or parked car, etc.)Collision with something other than a motor vehicle (bike, pedestrian, tree, curb, street sign, etc.)Lost control and fell down or off your bikeOther (please specify)

Other details

Was a vehicle involved in the incident which caused your collision, or that caused you to lose control?

YesNo

Property damage

Was your property damaged as a result of the incident?

YesNo

Please tell us what property was damaged as a result of the incident (e.g. your bike, clothing).

Please tell us the total cost of your property that was damaged.

Has the other party/s involved in the incident requested compensation from you?

YesNo

Tell us about yourself

Are you a Bicycle Network Member?

What is your rider number?

To which gender identity do you most identify?

How old are you?

Would you be willing to participate in follow-up research about your incident and how it has affected your riding?

YesNo

Name

Email

Do you require a follow up call from our Riders' Rights team to discuss your crash or make a claim?

YesNo

Please provide your best contact number

Thank you for completing our Near Miss and Crash Reporter survey.

If you're a Bicycle Network member and want to talk to our Riders' Rights team about your incident and what support we can offer you, or you'd like to talk to someone about your incident – please send us an email or call us on 1800 639 634.

Protecting your privacy
We collect, use, disclose and otherwise handle your personal information in accordance with the terms of our Privacy Policy Statement. All information remains the property of Bicycle Network.

We do not collect personally identifiable information about you except where you specifically provide this information on a voluntary basis. We will make every effort to ensure that whatever information you provide will be maintained in a secure environment.