Date of Incident:
(mm/dd/yyyy) Type of Incident:
Incident / Report Number
1. Was the deputy professional?
2. Were you treated with respect?
3. Were you treated fairly?
4. Do you feel the situation was
5. Understanding that this may
have been a difficult situation, were you generally satisfied with the Jefferson
County Sheriff's Office?
6. Was the deputy's response time:
7. Was the deputy's demeanor:
8. Was the deputy's ability to
handle the circumstance:
9. Your reaction:
Satisfied Dissatisfied Comments:
10. As a citizen of Jefferson County,
what is your greatest safety or security concern? Comments:
11. Do you have any
recommendations or suggestions for improvements for the Jefferson County
If so What:
12. If dissatisfied, do you wish
for a member of Sheriff's Command Staff to contact you in regards to this
Please provide your contact
13. Other Comments: