In the world of prescription drug regulation, there are a few notable exceptions to the rule. Dr 2447 Form is one such exception. This powerful painkiller has caused more than its fair share of controversy since it hit the market, and opinions on it are sharply divided. Advocates hail it as a miracle drug that can help people manage chronic pain without the side effects of traditional painkillers, while detractors claim that it is dangerously addictive and potentially deadly. So what is the truth about Dr 2447 Form? Let's take a closer look.
| Question | Answer |
|---|---|
| Form Name | Dr 2447 Form |
| Form Length | 6 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 30 sec |
| Other names | colorado department of revenue law enforcement form dr2447, state 80261 accident online, dr 2447 accident, colorado revenue accident |
MAIL TO: STATE OF COLORADO MOTOR VEHICLE TRAFFIC RECORDS DENVER, CO
AMENDED/SUPPL.
UNDER $1,000
COUNTER REPORT
PRIVATE PROPERTY PAGE ______ OF ______ PAGES
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INTERSTATE HWY |
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HWY NUMBER |
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DOR Code |
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STATE HWY |
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MILEPOINT |
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CITY ST/CNTY RD |
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Date of Accident |
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City |
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Agency |
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County |
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Time (24 Hr.) |
Officer Number |
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Officer Name |
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Signature |
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Detail |
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Number Killed |
Number Injured |
Location Route, Street, Road |
______ Miles ______ Feet |
N |
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S |
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E |
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W |
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OF: |
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___________________________________ |
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At: ___________________________________ |
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Date of Report |
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Latitude _________ |
_________ |
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_________ |
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Longitude _________ |
_________ |
________ |
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B |
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Agency Code |
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Investigated |
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Total Vehicles |
District Number |
Public Property/ |
Photos Taken |
Railroad Crossing |
Const. Zone |
Highway |
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Bridge |
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@ Scene |
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Employee |
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Related |
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Related |
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Interchg. |
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Related |
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B |
Traffic Unit # |
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Traffic Unit # |
Veh. |
Parked |
Bicycle |
Pedestrian |
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M |
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1 or _______ |
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Veh. |
Parked |
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Bicycle |
Pedestrian |
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Last Name |
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First |
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MI |
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Last Name |
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First |
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MI |
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Street Address |
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Personal Phone |
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Street Address |
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Personal Phone |
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( |
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( |
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City |
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State |
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ZIP |
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Bus. Phone |
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City |
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State |
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ZIP |
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Bus. Phone |
N |
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( |
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( |
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Driver License Number |
CDL |
State |
Sex |
DOB |
Driver License Number |
CDL State |
Sex |
DOB |
N |
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Primary Violation |
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Primary Violation |
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C |
DUI |
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DUI |
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Violation Code |
Citation Number |
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Common Code |
Violation Code |
Citation Number |
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Common Code |
P |
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Year |
Make |
Model |
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Body Type |
Year |
Make |
Model |
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Body Type |
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P |
License Plate Number |
State or Country |
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Color |
License Plate Number |
State or Country |
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Color |
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D |
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Vehicle Identification Number |
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Vehicle Identification Number |
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Vehicle Owner Last Name Same |
First |
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MI |
Vehicle Owner Last Name |
Same |
First |
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MI |
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E |
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Address Same |
City |
State ZIP |
Address Same |
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City |
State ZIP |
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Q
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Towed Due to Damage |
By: |
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Towed Due to Damage |
By: |
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Q |
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To: |
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To: |
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F |
Trailer VIN#___________________________ |
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Trailer VIN#___________________________ |
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1- Slight |
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1- Slight |
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2- Moderate |
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2- Moderate |
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G |
_____ Undercarriage |
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____ Undercarriage |
3- Severe |
_____ Undercarriage |
____ Undercarriage |
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3- Severe |
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Insurance Company |
None |
No Proof |
Exp. Date |
Insurance Company |
None |
No Proof |
Exp. Date |
R |
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Policy Number |
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Policy Number |
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R |
H |
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Owner Damaged Prop. |
Last Name |
First |
MI |
Address |
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City |
State |
ZIP |
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Owner Damaged Prop. |
Last Name |
First |
MI |
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Address |
City |
State ZIP |
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J |
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T.U. |
SAFETY |
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SUSPECTED |
INJ. |
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NAME / ADDRESS |
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# POS. REST. ENDO. |
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SEV. AGE |
SEX |
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S |
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EQUIP. |
AIR BAG EJECT ALCO DRUG |
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S |
T |
T |
Approved By
I.D. #
Date
AA
AA
BB
BB
CC
CC
DD
DD
EE
EE
FF
FF
GG
GG
GG
GG
PAGE ______ OF ______ PAGES
Case # |
DOR CODE |
Accident Date |
Agency |
HH
Describe Accident
HH
JJ
JJ
KK
KK
LL
LL
MM
MM
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NN |
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Carrier Name |
US DOT |
ICC |
State DOT |
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NN |
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T.U. |
Address |
Carrier Identification # |
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NN |
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Carrier Name |
US DOT |
ICC |
State DOT |
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# |
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NN |
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T.U. |
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Address |
Carrier Identification # |
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TRAFFIC ACCIDENT REPORT |
OVERLAY A |
A. LOCATION
01. On Roadway
02. Ran Off Left Side
03. Ran Off Right Side
04. Ran Off ‘T’ Intersection
05.Vehicle Crossed Center Median Into Opposing Lanes
06.On Private Property
B.HARMFUL EVENT SEQUENCE
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COLLISION WITH OBJECT |
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01. |
Overturning |
19. |
Light Pole / Utility Pole |
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02. |
Other |
20. |
Traffic Signal Pole |
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COLLISION WITH PEDESTRIAN |
21. |
Sign |
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03. |
School Age To / From School |
22. |
Guard Rail |
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04. |
Pedestrian on Toy Motorized Veh. |
23. |
Cable Rail |
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1st |
05. |
All Other Peds |
24. |
Concrete Highway Barrier |
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25. |
Bridge Structure |
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COLLISION WITH MOTOR VEHICLE |
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IN TRANSPORT |
26. |
Vehicle Debris or Cargo |
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06. |
Front to Front |
27. |
Culvert or Headwall |
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2nd |
28. |
Embankment |
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07. |
Front to Rear |
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08. |
Front to Side |
29. |
Curb |
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30. |
Delineator Post |
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09. |
Rear to Side |
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31. |
Fence |
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MOST |
10. |
Rear to Rear |
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32. |
Tree |
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11. Side to |
33. |
Large Rocks or Boulder |
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12. |
Side to |
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34. |
Railroad Crossing Equipment |
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COLLISION WITH OTHER VEHICLE |
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35. |
Barricade |
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13. |
Parked Motor Vehicle |
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36. |
Wall or Building |
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14. |
Railway Vehicle/Light Rail |
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37. |
Crash Cushion / Traffic Barrel |
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15. |
Bicycle |
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38. |
Mailbox |
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16. |
Road Maintenance Equipment |
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39. |
Other Fixed Object (Specify in |
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COLLISION WITH ANIMAL |
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Narrative) |
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17. |
Domestic Animal |
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40. |
Other Object (Specify in |
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18. |
Wild Animal |
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Narrative) |
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C. APPROACH/OVERTAKING TURN |
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01. |
Approach Turn |
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02. |
Overtaking Turn |
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03. |
Not Applicable |
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D. ROAD DESCRIPTION |
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01. |
At Intersection |
05. |
Alley Related |
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02. |
Driveway Access Related |
06. |
Roundabout |
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03. |
Intersection Related |
07. |
Highway Interchange |
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04. |
08. |
Parking Lot |
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E. ROAD CONTOUR |
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01. |
Straight |
04. |
Curve |
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02. |
Straight |
05. |
Hillcrest |
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03. Curve |
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F. ROAD SURFACE |
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01. |
Concrete |
05. |
Dirt |
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02. |
Blacktop |
06. |
Other (Describe in Narrative) |
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03. |
Brick or Block |
07. |
Unknown |
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04. |
Gravel, Slag or Stone |
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G. ROAD CONDITION |
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01. |
Dry |
08. |
Dry W/Visible Icy Road Treatment |
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02. |
Wet |
09. |
Wet W/Visible Icy Road |
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03. |
Muddy |
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Treatment |
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04. |
Snowy |
10. |
Snowy W/Visible Icy Road |
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05. |
Icy |
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Treatment |
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06. |
Slushy |
11. |
Icy W/Visible Icy Road Treatment |
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07. |
Foreign Material |
12. |
Slushy W/Visible Icy Road |
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Treatment |
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H. LIGHTING CONDITION
01. Daylight
02. Dawn or Dusk
03. Dark - Lighted
04. Dark - Unlighted
J. ADVERSE WEATHER CONDITION
00. |
None |
03. |
Fog |
01. |
Rain |
04. |
Dust |
02. |
Snow / Sleet / Hail |
05. |
Wind |
K. VEHICLE / VEHICLE COMBINATION
FMC (Overlay C) Required |
08. |
Pickup Truck / Utility Van W/Trailer |
|
01. |
Vehicle / Vehicle Combination |
09. |
SUV |
|
(10,001 lbs. and over) |
10. |
SUV W/Trailer |
02. |
School Bus (all school buses) |
11. |
Motor Home |
03. |
12. |
Motorcycle |
|
|
including driver) in commerce |
13. |
Bicycle |
04. |
Transit Bus |
14. |
Motorized Bicycle |
GVWR 10,000 lbs. or Less |
15. |
Farm Equipment |
|
05. |
Passenger Car / Passenger Van |
16. |
Hit & Run Unknown |
06. |
Passenger Car / Passenger Van W/ Trailer |
17. |
Light Rail |
07. |
Pickup Truck / Utility Van |
18. |
Other (Describe in Narrative) |
L. DIRECTION OF TRAVEL – PRIOR TO IMPACT
01. |
North |
05. |
South |
02. |
Northeast |
06. |
Southwest |
03. |
East |
07. |
West |
04. |
Southeast |
08. |
Northwest |
M. VEHICLE MOVEMENT – PRIOR TO IMPACT
01. |
Going Straight |
10. |
Parked |
02. |
Slowing |
11. |
Changing Lanes |
03. |
Stopped in Traffic |
12. |
Avoiding Object in Roadway |
04. |
Making Right Turn |
13. |
Weaving |
05. |
Making Left Turn |
14. |
Spun Out of Control |
06. |
Making |
15. |
Drove Wrong Way |
07. |
Passing |
16. |
Other (Describe in Narrative) |
08. |
Backing |
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09. |
Entering / Leaving Parked Position |
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N. ROADWAY SPEED LIMIT - Vehicles Only
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Traffic Unit #1 or ________ |
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Traffic Unit #2 or ________ |
P. ESTIMATED VEHICLE SPEED - Vehicles Only |
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Traffic Unit #1 or ________ |
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Traffic Unit #2 or ________ |
Q. DRIVER ACTIONS (Officer Opinion Only) |
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00. |
No Action |
10. |
Lane Violation |
01. |
Exceeded Safe/ Posted Speed |
11. |
Improper Passing on Left |
02. |
Impeded Traffic |
12. |
Improper Passing on Right |
03. |
Failed to Yield ROW |
13. |
Followed Too Closely |
04. |
Disregard Stop Sign |
14. |
Improper Backing |
05. |
Failed to Stop at Signal |
15. |
Signaling Violation |
06. |
Disregarded Other Device |
16. |
Reckless Driving |
07. |
Improper Turn |
17. |
Careless Driving (if used, |
08. |
Turned from Wrong Lane or Position |
|
block R can not be coded "00") |
09. |
Other Improper Turns |
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R. DRIVER - MOST APPARENT HUMAN CONTRIBUTING FACTOR (Officer Opinion Only)
00. |
No Apparent Contributing Factor |
09. |
Physical Disability |
|
01. |
Asleep at the Wheel |
10. |
DUI, DWAI, DUID |
|
02. |
Driver Fatigue |
11. |
Distracted / Passenger |
|
03. |
Illness / Medical |
12. |
Distracted / Cell Phone |
|
04. |
Driver Inexperience |
13. |
Distracted / Radio |
|
05. |
Aggressive Driving |
14. |
Distracted / Other |
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06. |
Driver Unfamiliar With Area |
|
i.e. Food, Objects, Pet, etc. |
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15. |
Other Factor (Describe |
|||
07. |
Driver Emotionally Upset |
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in Narrative) |
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08. |
Evading Law Enforcement Officer |
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S. BY PEDESTRIAN ACTION (Officer Opinion Only) 01. Cross Against Signal
02. Cross / Enter at Intersection
03. Cross / Enter NOT at Intersection
04. Standing in Roadway
05. Playing in Roadway
06. Soliciting Rides
07. Walking in Roadway in Direction of Traffic
08. Walking in Roadway Against Direction of Traffic
09.Entering / Exiting Vehicle
10.Pushing / Working on Vehicle
11.Lying in Roadway
12.Other (Describe in Narrative)
T. VEHICLE DEFECT / CONDITION (Officer Opinion Only)
00. |
No Vehicle Defects |
10. |
Improper Load |
01. |
Defective Head Light(s) |
11. |
Spilled Load – Commercial |
02. |
Defective Brake/Tail Light(s) |
|
Aggregate |
03. |
Defective Signaling Device |
12. |
Spilled Load – Commercial |
04. |
Brakes Defective/Out of Adjustment |
|
Non- Aggregate |
05. |
Defective Tires |
13. |
Spilled Load – Other |
06. |
Sudden Tire Failure |
14. |
Parking Violation |
07. |
Improper Tires for Conditions |
15. |
Other Defect(s) (Describe |
08. |
Mechanical Failure |
|
in Narrative) |
09. |
Obstructed Window(s) |
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OVERLAY B
Traffic Unit #
Position In / On Vehicle
14
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03 |
06 |
09 |
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01. |
Driver |
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Passengers |
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10. |
Other ENCLOSED passenger/cargo area |
➟ |
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10/11 |
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11. |
Other |
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02 |
05 |
08 |
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13 |
12. |
Sleeper Section of Truck |
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12 |
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13. |
Trailer |
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14. |
Riding/Hanging on to Exterior of vehicle or trailer |
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01 |
04 |
07 |
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15. |
Pedestrian |
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Compliance with Driving Restrictions 00. Not Restricted |
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01. Complied With Restrictions |
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02. Did Not Comply With Restrictions |
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03. Compliance With Restrictions Not Known |
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Compliance with Driving Endorsements 00. No Driving Endorsements
01.Endorsements Required and Complied With
02.Endorsements Required and Not Complied With
03.Endorsements Required and Compliance Not Known
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Safety equipment used |
SYSTEM |
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USE (Restraints & MC Eye |
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HELMET |
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F. Unknown |
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A. None |
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Protection) |
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A. N/A (Cars/Trucks) |
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B. Shoulder and Lap Belt |
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00. Not used |
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B. No Helmet |
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G. Bicycle Helmet |
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C. Shoulder belt only |
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01. Properly used |
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C. Available, not used |
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D. Lap belt only |
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02. Improperly used |
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D. Helmet Improperly used |
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E. Child safety restraint |
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03. Unknown |
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E. Helmet Properly used |
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F. Motorcycle |
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04. Bicycle |
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G. Bicycle |
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Air Bag |
00. Not Equipped |
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04. Not deployed at pos., |
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A. None |
D. Curtain |
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01. Not Deployed |
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deployed at others |
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B. Front |
E. Rear |
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02. Deployed at pos. only |
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05. Unknown |
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C. Side |
F. Multiple |
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03. Deployed at pos. & others |
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Ejection |
00. |
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No |
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02. |
Yes - Full |
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01. |
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Yes - Partial |
03. |
Extricated |
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Suspected alcohol |
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00. |
No |
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(Officer Opinion Only) |
01. |
Yes |
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02. Unknown |
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Suspected drugs |
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00. |
No |
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(Officer Opinion Only) |
01. |
Yes |
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02. Unknown |
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Injury Severity |
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00. |
No injury |
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03. |
Evident - incapacitating |
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01. |
Complaint of injury |
04. |
Fatal |
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02. Evident - |
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Age Age MUSTBEin whole Numbers (Under the Age of 1 year Age = 0 ) |
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) |
Sex |
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=0 |
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Suspectedalcohol(OfficersOpinionOnly) |
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AgeAgeinwholeNumbers(UndertheAgeof1yearAgeMUSTBE |
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Name / Address |
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TrafficUnit# |
PositionIn/OnVehicle |
CompliancewithDrivingRestrictions |
CompliancewithDrivingEndorsements |
SafetyEquipmentUsed |
AirBag |
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AirBag |
Ejection |
Suspecteddrugs(OfficersOpinionOnly) |
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InjurySeverity |
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Sex |
Name / Address |
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FEDERAL MOTOR CARRIER INFORMATION |
|
OVERLAY C |
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AA. CARRIER TYPE |
HH. HAZARDOUS MATERIALS |
||
01. |
Interstate |
Did the vehicle have a hazardous material placard? |
|
02. |
Intrastate |
00. |
No |
03. |
Government Vehicle (10,001lbs. GVWR and over) |
01. |
Yes |
04.Not in Commerce (10,001lbs. GVWR and over)
(If #4 is chosen, complete onlyblocks CC, DD, EE, FF, and GG or NN.)
BB. SOURCE OF NAME |
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01. |
Log Book |
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02. |
Shipping Papers, Truck, Bus, or Trip Manifest |
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JJ. HAZARDOUS MATERIALS |
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03. |
Driver |
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04. |
Side of Vehicle |
Was hazardous cargo from the placarded truck released? |
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(Do not count fuel from the vehicle fuel tank) |
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00. |
No |
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CC. GROSS VEHICLE WEIGHT RATING |
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01. |
Yes |
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01. |
Under 10,001 Pounds |
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02. |
10,001 to 26,000 Pounds |
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03. |
26,001 Pounds and Over |
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DD. TOTAL NUMBER OF AXLES |
KK. HAZARDOUS MATERIALS |
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|||||||
Enter the total number of axles including truck and trailer. |
Enter the fourdigit number from the placard. If no number on the placard |
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enter the fourdigit identification number from the shipping paper(s). |
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KK |
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➟ |
1 |
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3 |
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6 |
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9 |
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EE. VEHICLE CONFIGURATION |
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Sample |
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01. |
Passenger Car (only if HM placarded) |
LL. HAZARDOUS MATERIALS |
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02. |
Light Truck (only if HM placarded) |
Enter the one digit number taken from the bottom of the placard. |
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03. |
Bus/ Limousine |
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04. |
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05. |
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06. |
Truck and Trailer |
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07. |
Truck Tractor (Bobtail) |
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08. |
Truck Tractor and |
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09.Truck Tractor and Double Trailers
10.Truck Tractor and Triple Trailers
11.Other (Describe in narrative)
FF. CARGO BODY TYPE |
MM. LIQUID HAZARDOUS MATERIALS |
||
01. |
Bus/ Limousine (seats |
Enter the amount of bulk liquid cargo at time of accident. |
|
02. |
Bus/Limousine (seats 16 or more occupants including the driver) |
01. |
0 to 1,000 gallons |
03. |
Van/ Enclosed Box |
02. |
1,001 to 2,000 gallons |
04. |
Cargo Tank |
03. |
2,001 to 3,000 gallons |
05. |
Flatbed/Pickup |
04. |
3,001 to 4,000 gallons |
06. |
Dump Bed |
05. |
4,001 to 5,000 gallons |
07. |
Concrete Mixer |
06. |
5,001 to 6,000 gallons |
08. |
Auto Transporter |
07. |
6,001 to 7,000 gallons |
09. |
Garbage Refuse |
08. |
7,001 to 8,000 gallons |
10. |
Grain, Chips, Gravel |
09. |
8,001 gallons and over |
11.Pole
12.Intermodal Container
13.Vehicle Towing another Vehicle
14.Fire Aparatus
15.Ambulance
16.No Cargo Body
17.Other (Describe in Narrative)
GG.
Block AA Top
1st
2nd
3rd
SEQUENCE OF ACCIDENT EVENTS
COLLISION |
|||
01. |
Ran Off the Road |
11. |
Pedestrian |
02. |
Jackknifed |
12. |
Motor Vehicle inTransport |
03. |
Overturning |
13. |
Parked Motor Vehicle |
04. |
Downhill Runaway |
14. |
Train |
05. |
Cargo Loss or Shift |
15. |
Pedal Cycle (Bicycle, Tricycle, etc.) |
06. |
Explosion or Fire |
16. |
Animal |
07. |
Separation of Units |
17. |
Fixed Object |
08. |
Crossed the Median/Center Line |
18. |
Work Zone Maintenance Equipment |
09. |
Equipment Failure (Tires, etc.) |
19. |
Other Movable Object |
10. |
Other (Describe in Narrative) |
20. |
Other (Describe in Narrative) |
NN.
Block AA Bottom
1st
2nd
3rd
4th |
4th |
COLORADO INVESTIGATOR’S FATAL TRAFFIC ACCIDENT SUPPLEMENTAL REPORT
PAGE ______ OF ______ PAGES
Case #
DOR CODE
Accident Date
Agency
EMERGENCY MEDICAL SERVICES
(Record all time using 24 Hr. time)
Time Notified |
Time Arrived @ Scene |
Time Arrived @ Hospital |
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If times are unknown provide name of responding services
TRAFFICWAY FLOW
01. Not Divided (Two Way)
02.Divided, Median W/O Barrier
03.Divided, Median W/Barrier
04.One Way
NUMBER OF TRAVEL LANES
If the accident is totally contained on half of a divided highway (physical barrier not painted median), only count the number of travel lanes on that half.
ACCIDENT AVOIDANCE MANEUVER
00. No Avoidance Maneuver
01. Braking (Skid marks evident)
02.Braking (Per driver, no skid marks evident)
03.Braking (Per witness, no skid marks evident)
04.Steering (Evidence or stated)
05.Steering & Braking (Evidence or stated)
06.Other Avoidance Maneuver
FIRE/HAZARDOUS MATERIALS INVOLVEMENT
00. No Fire/No
01.No
02.No
03.Vehicle Fire/No
04.Vehicle
05.Vehicle
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Traffic |
Traffic |
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Traffic |
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Unit #2 |
Unit #3 |
Unit #4 |
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or ___ |
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Traffic |
Traffic |
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Traffic |
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Traffic |
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Unit #2 |
Unit #3 |
Unit #4 |
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or ___ |
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TRAFFIC CONTROL DEVICE FUNCTIONING
01.No Controls
02.Not Functioning
03.Functioning Improperly
04.Functioning Properly
05.Unknown
List the Most Significant Types of Traffic Control Devices
MUST BE COMPLETED FOR ALL PERSONS INVOLVED EXCEPT UNINJURED BUS/RAILWAY PASSENGERS.
(A)Traffic Unit Number (list Traffic Unit Number as on DR 2447)
(B)Position in Vehicle
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➟
03 |
06 |
09 |
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10/11 |
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01. Driver
10.Other ENCLOSED passenger/cargo area
11.Other
12.Sleeper Section of Truck
13.Trailer
14.Riding/Hanging on to Exterior of Vehicle or Trailer
15.Pedestrian
(C) Ejection Path 00. |
Not Ejected/ Not applicable |
04. |
Through Back Window |
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08. Other Path (e.g. back of pickup truck) |
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01. |
Through Side Door Opening |
05. |
Through Back Door/Tailgate Opening |
09. |
Unknown |
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02. |
Through Side Window |
06. |
Through Roof Opening (sun roof/convertible top down) |
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03. |
Through Windshield |
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07. |
Through Roof (convertible top up) |
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(D) Alcohol Suspected |
Yes > 01. |
Preliminary Breath Test |
04. |
Passive Alcohol Sensor |
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No > 06. |
Preliminary Breath Test |
09. |
Passive Alcohol Sensor |
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(Officer Opinion Only) |
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02. |
SFST |
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05. |
Other method |
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07. |
SFST |
10. |
Other method |
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03. |
Observed |
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08. |
Observed |
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(E) Tested for Alcohol |
00. |
Not Tested |
03. |
Urine |
06. By Coroner |
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01. |
Blood |
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Other |
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02. |
Breath |
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05. |
Refusal |
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(F) Other Drug/Impairment Suspected |
Yes > 01. |
Drug Recognition Expert |
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No > 05. |
Drug Recognition Expert |
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(Officer Opinion Only) |
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02. |
SFST |
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06. |
SFST |
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03. |
Observed |
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07. |
Observed |
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04. |
Other |
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08. |
Other Method |
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(G) Tested for Other Drugs |
00. Not Tested |
02. Breath |
04. Other |
06. By Coroner |
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01. Blood |
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03. Urine |
05. Refusal |
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(H)Dead at Scene 00. No
01.Yes
Name
Taken to
Date Expired Time