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Citizen Survey Form

Thank you for your comments. In the event that we would need to address any concerns you may have, fill in as much of the information below as possible.
Name:

Address:

Address Line 2:

City or Town:

State or Province:

Zip Code:

Phone:

Email:

If you telephoned your incident to the Police Dispatcher, was the dispatcher helpful and courteous?

Did the Police Officer arrive at the incident in a timely manner?

Did the Police Officer explain what he / she would do to act upon your concerns and / or complaint?

Was the Police Officer courteous?

Do you believe the Police Officer handled the incident in an efficient and effective manner?

Do you have any other comments about the Officer who handled this incident for you?

Please specify below:

Do you have any other comments as to how the West Bend Police Department can improve the level of service to the West Bend community?

If yes, please list below:

Incident Date & Time :

Incident # :

Incident Location :

Type of Call :

Police Officer :


     
1115 S. Main Street
West Bend, WI 53095
(262) 335-5100

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