Service ID Number:
*
Date of Service:
*
Current residential ZIP Code:
Age:
18 - 30
51 - 60
31 - 40
61 - 70
41 - 50
71+
Type of Service received:
*
Structure Fire
Vehicle Fire
Auto Accident Incident
Carbon Monoxide
Emergency Medical Service
Smoke/Odor Investigation
Other
If other, please explain:
My call to 9-1-1 was answered promptly. If you did not call 9-1-1, please select “Not Applicable”.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
The 9-1-1 Operator handled my call in a professional and courteous manner. If you did not call 9-1-1, please select “Not Applicable”.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
Please rate the overall service you received from the Park Forest Firefighters/Paramedics.
*
Exceeded Expectations
Met Expectations
Did Not Meet Expectations
The Park Forest Fire Department responded to my call for assistance in a prompt and timely manner.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
The response from the Park Forest Fire Department was helpful and addressed my problem/concerns.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
The Park Forest Fire Department personnel were professional and knowledgeable in responding to my needs.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable
Were there any services you believe should have been provided that were not?
No
Yes
If yes, please explain:
Please use the space below for any additional comments, complaints, compliments or concerns.
May we contact you regarding your survey?
No
Yes (Please provide name and phone number below.)
Name:
Phone Number:
Submit
Should be Empty: