Passenger Incident and Injury Report

Documents passenger injuries or incidents aboard a vehicle or while boarding and alighting. Supports risk management, corrective action, and regulatory reporting.

Submission Notice

• Reporter name
• Reporter role
• Reporter contact email or phone
  Optional. Use only if follow-up is needed.
• Date of incident
• Time of incident

Incident Details

• Type of incident
• Location of incident
• Route, trip, or service name
  Optional. Enter only if it helps identify the trip.
• Incident description
  Describe the sequence of events, including what the passenger was doing immediately before the incident.
• Contributing factors

Passenger Information

• Passenger name
  Optional unless required for follow-up or reporting.
• Passenger contact information
  Optional. Do not collect more PII than needed.
• Passenger age group
• Mobility aid or assistive device used
• Was an interpreter or reasonable accommodation needed?

Injury and Medical Response

• Did an injury occur?
• Injury description
  Describe the apparent injury using minimum necessary detail.
• Medical response provided
• Was an emergency contact notified?
• Medical facility or destination

Witnesses and Immediate Response

• Were there witnesses?
• Witness details
• Immediate actions taken
• Scene notes
  Include any hazards, equipment issues, or operational conditions that may have contributed.

Follow-up and Review

• Supervisor notified
• Risk management notified
• Corrective actions or preventive measures
  Describe any actions taken to reduce the chance of recurrence.
• Supporting attachments
  Optional. Upload photos, statements, or related documents.