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 Department Feedback Form

  1. We want to hear from you
    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. This feedback is provided on
  3. Timeliness
    The Police Department response was timely.
  4. Effectiveness
    My issue was handled effectively.
  5. Professionalism
    The Police Department member was professional.
  6. Incident Number
    The Police Department member provided me with the incident case number.
  7. Contact Information
    The Police Department Member provided me with their name and ID number.
  8. Follow-up
    The Police Department member provided me with information on who to contact with additional questions or information.
  9. Satisfaction
    I am satisfied with the visibility of police in my neighborhood.
  10. Crime Efforts
    I am satisfied with the City of Derby's efforts to reduce crime.
  11. Leave This Blank:

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