Brookline Police Interaction Civilian Feedback Form

Interaction Information

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1. On what date did this interaction happen? (Required.)

Interacton Date

Date

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2. Optionally, at what time of day did this interaction happen?

Encounter Start Time

Time

AM/PM

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3. Describe what happened and where and how you felt about it. Please be as specific as possible. (Required.)

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4. Overall, how would you rate this interaction with the Brookline Police? (Required.)

Very Negative

Somewhat Negative

Neutral

Somewhat Positive

Very Positive

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5. Would you like to identify any police personnel involved? (Required.)

Yes

No