Title Page
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Event Number(s)?
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Driver's Name for this DriveCam Face-to-Face Coaching?
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Conducted on
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Prepared by
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What Was The Nature Of This DriveCam?
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Seat Belt
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Cell Phone
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Electronic Device
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Following Too Close
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Late Response
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Too Fast For Conditions
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Rolling Stop
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Red Light/Stop Sign
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Not Looking Far Enough
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Hard Braking
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Food/Drink
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What Was Discussed?
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Supervisor's Signature
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Driver Comments(if any)
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Driver's Signature
