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Fire & Ambulance Services - Citizen Survey & Feedback Form

2. Were you greeted in a friendly manner?*
   -- Select One --YesNo

4. Did you feel you were treated with respect?*
   -- Select One --YesNo

6. Did the county employee attempt to answer your questions fully?*
   -- Select One --YesNo

8. Do you feel that the employee(s) you dealt with were knowledgeable and understood the business of the Fire Department?*
   -- Select One --YesNo

10. Were you treated in a professional manner?*
    -- Select One --YesNo

12. If your contact was by phone, was the department or agency identified when the phone was answered?*
    -- Select One --YesNo

14. If your contact was by phone, did the employee identify themselves, and offer to assist you?*
    -- Select One --YesNo

16. How would you rate the overall service that you received from our employee(s)?*
    -- Select One --GoodAveragePoor

18. What is your overall evaluation of the Fire Department?*
    -- Select One --GoodAveragePoor

20. Any other suggestions or comments?

22. Submitting contact information is optional. Your contact information will be kept in strictest confidence, and will not be shared with any outside parties.

    Submitting contact information is optional. Your contact information will be kept in strictest confidence, and will not be shared with any outside parties.

24. Name

26. Phone

27. Email

29. May we contact you about your comments?
    -- Select One --YesNo

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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field