Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Police Officer Feedback Form

  1. Please provide your feedback on your interactions with the Derby Police Department. Your responses will help us do a better job and make any needed changes. Choose a rating that best represents your opinion of our services.

  2. The police response was timely.

  3. My issue was handled effectively.

  4. The officer was professional.

  5. The officer provided me with the incident case number.

  6. The officer provided me with their name and ID number.

  7. The officer provided me with information on who to contact with additional questions or information.

  8. I am satisfied with the visibility of police in my neighborhood.

  9. I am satisfied with the City of Derby's efforts to reduce crime.

  10. Leave This Blank:

  11. This field is not part of the form submission.