The questionnaire has been setup by John Campion, who is the Conservative candidate for the Police and Crime Commissioner Election in West Mercia this May.
It consists of ten questions including asking the most pressing crime problems being faced and how the police in West Mercia should be funded.
You can fill out the questionnaire by visiting www.campion4westmercia.com/survey or a paper copy can be provided by phoning 01562 823915.
Mr Campion was selected as the Conservative candidate for the post in October and has lived in the area all his life, previously working for the prison service.
John Campion said: “Over the last few months I have knocked on hundreds of doors as part my campaign but sometimes people are at work or out with the family.
“This is why I have setup this survey so you can let me know how policing can be improved in the comfort of your home in just a couple of minutes.
“I will make sure to collate the responses and take the problems straight to West Mercia Police to get action on crime in your area.”