2. 
4. Thank you for taking time to complete this feedback form. The information provided will help the Fire Department develop and provide services and programs important to our residents.
6. Name*
8. Address
10. City
11. State
12. Zip Code
14. Email
16. 1. What is your current level of satisfaction with the current fire services provided by the Fire Department?

    1. Excellent
    2. Good
    3. Fair
    4. Poor
17. 2. What is your current level of satisfaction with the current Emergency Medical Services (EMS) provided by the Fire Department?

    1. Excellent
    2. Good
    3. Fair
    4. Poor
19. Comments (no character limit)
21. Fire Department Phase II Program
    The next set of questions relate to your support for different aspects of the Fire Department's Phase II Program.
23. 1. Phase II in its entirety:

    1. Strongly Support
    2. Support
    3. Somewhat Support
    4. Do Not Support
24. 2. Community Fire Response:

    1. Strongly Support
    2. Support
    3. Somewhat Support
    4. Do Not Support
26. 3. Advanced Life Support First Response:

    1. Strongly Support
    2. Support
    3. Somewhat Support
    4. Do Not Support
27. 4. Enhanced Fire Prevention and Inspections:

    1. Strongly Support
    2. Support
    3. Somewhat Support
    4. Do Not Support
29. 5. Emergency Medical Services Prevention and Community Health Programs:

    1. Strongly Support
    2. Support
    3. Somewhat Support
    4. Do Not Support
31. Comments (no character limit)
33. Do you support the Fire Department's ability to increase firefighter staffing to assure safe and proper emergency response?

    1. Yes
    2. No

35. Thank You!
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

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