FOND DU LAC POLICE DEPARTMENT
Survey Form

Based on your most recent contact, please rate the following areas:

Concern
Excellent Good Fair Poor Very Poor

Helpfulness
Excellent Good Fair Poor Very Poor

Knowledge
Excellent Good Fair Poor Very Poor

Fairness
Excellent Good Fair Poor Very Poor

Solving the Problem
Excellent Good Fair Poor Very Poor

Putting You at Ease
Excellent Good Fair Poor Very Poor

Professional Conduct
Excellent Good Fair Poor Very Poor

Response Time
Excellent Good Fair Poor Very Poor

Quality of Service
Excellent Good Fair Poor Very Poor

What was the Nature of Your Most Recent Contact (check any that apply)
I called the Department to report an incident I was the victim of a crime I was the witness to a crime or incident I was involved in a motor vehicle accident I requested information from the Department I was arrested I was issued a citation I was contacted about a problem or disturbance I was involved in another way with the Department

How Many Contacts Have You Had With the Fond du Lac Police Department in the Past Year
One Two Three or more

Please Tell Us How Can We Improve The Quality Of Our Service

Please Tell Us About You

I Am:
Male Female
My Race Is:
White Black Hispanic Other
My Age Is:
Under 17 18 - 20 21 - 24 25 - 39 40 - 55 56 +
I Earn:
Under $5,000 $5 - $19,000 $20 - $34,000 $35,000 or More
I Live In:
City of Fond du Lac Other

(Optional)

First Name:

Middle Name:

Last Name:

E-mail Address:

Street Address:

City/State/Zip:

Phone Number:

Name Of Officer If Known: