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2. Please fill out the following questions based on your experience with the Jacksonville Police Department/911 Dispatch Center personnel. We appreciate your feedback!
4. First Name
5. Last Name
7. Address1
9. City
10. State
11. Zip
13. Email:
14. Phone:
16. 1- Are you a resident of Jacksonville?*

    1. Yes
    2. No
17. 2 - Do you own a business in the City of Jacksonville?*

    1. Yes
    2. No
19. 3 - In the past year, have you or someone in your household had contact with Jacksonville Police or Jacksonville 911 Dispatch? (If you answer no, skip to question 21)*

    1. Yes
    2. No
21. 4 - If you answered 'Yes' to question 3, what type of contact did you have? Please check all that apply:

    1. Reported a crime
    2. Victim of a crime
    3. Witness to a crime
    4. Requested information

    1. Involved in a traffic accident
    2. Witnessed a traffic accident
    3. Attended a public event

    1. 9-1-1 Call
    2. RUOK Wellness Call
    3. Other
23. 5- If you answered 'Other' to question 4, what type of contact did you experience?
25. 6- Please provide the date/time of the contact to the best of your knowledge (we understand exact times may be unknown)
    6- Please provide the date/time of the contact to the best of your knowledge (we understand exact times may be unknown)

    6- Please provide the date/time of the contact to the best of your knowledge (we understand exact times may be unknown)
27. 7- If you had more than one contact in the past year, please use this space to write the dates/times for each experience. If you only had one experience, skip this question.
29. Please rate your overall experience based on your answer(s) to Question 4 (Only answer those that you checked in Question 4)
31. 8- Reported a crime

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
32. 9- Victim of a Crime

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
34. 10- Witness to a crime

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
35. 11- Requested Information

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
37. 12- Involved in a Traffic Accident

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
38. 13- Witnessed a traffic accident

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
40. 14- Attended a public event

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
41. 15- 9-1-1 call

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
43. 16- RUOK wellness call

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
44. 17- Other

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
46. 18 - How would you rate the overall agency performance?

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
48. 19- How would you rate the overall competence of the agency employees?

    1. Excellent
    2. Above Average
    3. Average

    1. Below Average
    2. Poor
50. 20 - Based on your experience with the Jacksonville Police Department, please explain your perception of the personnel's attitude and behavior:
52. 21- What primary community concern do you believe needs to be addressed by Jacksonville Police?*

    1. Crime
    2. Traffic
    3. No concerns
    4. Other
54. If you answered "Other" to Question 21, please state your area of primary concern.
56. 22- To what degree do you agree or disagree with the following statement: I am concerned with safety and security within the City of Jacksonville.*

    1. Strongly Agree
    2. Agree
    3. Neutral
    4. Disagree
    5. Strongly Disagree
58. If you answered "agree" or "strongly agree" to Question 22, please briefly describe your concern(s) over safety and security within the City of Jacksonville
60. 23 - Please share your recommendations or suggestions for improvement:
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

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