Intake Form: Test

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Intake Form: Commendation or Complaint

I Was:

My Information

I Am:

Full Name: (If you wish to be anonymous, please type "Anonymous" in the name field.)
Please Check One:
If Yes, Then: (Check All That Apply)

I Have This Information Regarding The Interaction

(Select All that Apply)
Media (Select All that Apply)

I Know This Information About The Officer(s)

Please include information like: gender, race, approximate age, size, glasses, tattoos, and anything else that would help identify the officer(s)

The Following People Were Around / Witnessed This Interaction

(This is more important for complaints)

Please Describe The Interaction Of The Officer(s)

• If this was a commendation, please describe why this interaction was helpful or positive.
• If this is a complaint, please describe why this interaction was problematic or negative.

Accountability breeds response-ability.

― Stephen R. Covey