Indicates required field Please provide your incident reference number Please select the location of the incident - Select -North WalesSouth Wales Date of incident Date of incident: Day Day12345678910111213141516171819202122232425262728293031 Date of incident: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of incident: Year Year20212020201920182017 Which of the following statements most closely matches the nature of the incident you were involved in? - Select -My vehicle broke downI was involved in a collisionI was asked to take part in a traffic surveyThe traffic officer removed my vehicle from a trunk roadOther (please specify below) Can you estimate the length of time between the start of the incident you were involved in and the arrival of the traffic officer? - Select -0-10 minutes10-20 minutes30-40 minutesOver 40 minutes Did the traffic officer identify herself/himself to you? Did the traffic officer identify herself/himself to you? Yes No Can't remember How helpful was the traffic officer? How helpful was the traffic officer? Very helpful Quite helpful Neither helpful or unhelpful Quite unhelpful Very unhelpful Did the service the traffic officer provided make you feel safe? Did the service the traffic officer provided make you feel safe? Yes No Can't remember How would you rate the overall service that the traffic officer provided? - Select -Very goodQuite goodNeither good nor poorQuite poorVery poor Please let us know any comments you may have in the box below Do not include any personal details in this field such as names or email addresses. Submit Leave this field blank .