Local submission prototype

This source-only form builds a schema-valid report for local workflow testing. It is not deployed and does not send data anywhere unless a developer explicitly configures an intake endpoint. Every field except location is optional.

Your privacy

We ask for no name, email, account, or phone number — and please keep them out of the note too.
Your submission is reviewed by a person before it counts. Nothing you send appears on the map as-is.
We publish only aggregated street-block rates: never your exact spot, never the time, never any identifier. Low-count blocks are withheld entirely.
Full detail: docs/THREAT-MODEL.md and docs/SUBMISSIONS.md.

Where did it happen? (required)

Use your current location, or type a place. We snap it to a public street block and never publish the precise point.

Latitude

Longitude

…or a street / intersection

What kind of hazard? (required)

Close pass (vehicle too close) Dooring (car door) Surface hazard (pothole, etc.) Blind corner / sightline Signal conflict Debris in the path Other

How serious? (required)

Near miss (no contact) Minor (contact / fall, little injury) Serious (significant injury)

This is your own assessment, never presented as a medical or police classification.

A few more details (optional)

How were you travelling?

Submission language

What happened? (optional)

Please do not include names, license plates, phone numbers, or emails. Notes are kept private and are never republished verbatim.

Your privacy

Your submission is ready for review