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Phone
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Property Address
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Address
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Priority Level
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Type of problem
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Heating
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How many of your neighbors do you know?
All of them
Most of them
Some of them
A few of them
None of them
How strong is the sense of community in this neighborhood?
Extremely strong
Very strong
Moderately strong
Slightly strong
Not at all strong
How often do you attend events in this neighborhood?
Extremely often
Very often
Moderately often
Slightly often
Not at all often
How often do you participate in activities in this neighborhood?
Extremely often
Very often
Moderately often
Slightly often
Not at all often
If you do not participate in activities in this neighborhood, why not?
If you do not participate in activities in this neighborhood, why not?
What types of events would you attend if they were held in this neighborhood?
What types of activities would you participate in if they were available in this neighborhood?
How often do you visit the parks in this neighborhood?
Extremely often
Very often
Moderately often
Slightly often
Not at all often
Are you satisfied with the parks in this neighborhood, neither satisfied nor dissatisfied with them, or dissatisfied with them?
Extremely satisfied
Moderately satisfied
Slightly satisfied
Neither satisfied nor dissatisfied
Slightly dissatisfied
Extremely dissatisfied
How well are the streets in this neighborhood maintained?
Extremely well
Very well
Moderately well
Slightly well
Not at all well
How safe do you feel in this neighborhood?
Extremely safe
Very safe
Moderately safe
Slightly safe
Not at all safe
How clean is this neighborhood?
Extremely clean
Very clean
Moderately clean
Slightly clean
Not at all clean
How proud are you to live in this neighborhood?
Extremely proud
Very proud
Moderately proud
Slightly proud
Not at all proud
What do you like most about this neighborhood?
What do you like least about this neighborhood?
What changes would most improve this neighborhood?
How promising is the future of this neighborhood?
Extremely promising
Very promising
Moderately promising
Slightly promising
Not at all promising
Overall, are you satisfied with your experience living in this neighborhood, neither satisfied nor dissatisfied with it, or dissatisfied with it?
Extremely satisfied
Moderately satisfied
Slightly satisfied
Neither satisfied or dissatisfied
Slightly dissatisfied
Moderately dissatisfied
Extremely dissatisfied
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Please describe the incident you would like to report.
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