Brookline Police Interaction Civilian Feedback Form

Interaction Information

Question Title

* 1. On what date did this interaction happen?

Interacton Date

Date

Question Title

* 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.

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* 4. Overall, how would you rate this interaction with the Brookline Police?

Very Negative

Somewhat Negative

Neutral

Somewhat Positive

Very Positive

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* 5. Would you like to identify any police personnel involved?

Yes

No