Form Center

2. First Name
3. Last Name
5. Phone
6. Email
8. Would you like to be contacted regarding my submission*

   1. Yes
   2. No
9. What type of interaction happened?*
   -- Select One --Community eventFire incidentMedical emergencyTraffic StopVictim of a crimeWitness or bystanderOther
11. What is your case number (if you know it)
12. What is your citation number (if you know)
14. Who are you rating?

    1. Civilian Employee
    2. Firefighter
    3. Investigator/Detective
    4. Patrol Officer/First Responder
    5. Public Safety Officer
    6. School Resource Officer
    7. Supervisor
    8. Other (explain in Tell Us More section)
15. The employee was respectful during the interaction?*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Not at all 5 equals Very

    
    

17. The employee was knowledgeable*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Not at all 5 equals Very

18. The employee explained the next steps*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Not at all 5 equals Thoroughly

20. I would want this employee to help me in the future*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Not at all 5 equals Yes, very confident

21. Rate your confidence in The New Brighton Department of Public Safety*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Not at all 5 equals Highly confident

23. Rate your overall experience with us*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5

    1 equals Poor 5 equals Excellent

25. Tell us more!*
Leave This Blank:


27. Submit

* indicates a required field