Customer Satisfaction Survey
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How Are We Doing?
We're committed to monitoring the quality of the services we provide, as part of an ongoing improvement process. We would appreciate your feedback on our performance. (All submissions are anonymous.)
1
. Please rate the following aspects of our work.
Excellent
Good
Adequate
Poor
Unacceptable
N/A
Communicating clearly and effectively
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Please rate the following aspects of our work. Communicating clearly and effectively Excellent
Communicating clearly and effectively Good
Communicating clearly and effectively Adequate
Communicating clearly and effectively Poor
Communicating clearly and effectively Unacceptable
Communicating clearly and effectively N/A
Keeping you informed during your service
Keeping you informed during your service Excellent
Keeping you informed during your service Good
Keeping you informed during your service Adequate
Keeping you informed during your service Poor
Keeping you informed during your service Unacceptable
Keeping you informed during your service N/A
Our level of empathy for your situation
Our level of empathy for your situation Excellent
Our level of empathy for your situation Good
Our level of empathy for your situation Adequate
Our level of empathy for your situation Poor
Our level of empathy for your situation Unacceptable
Our level of empathy for your situation N/A
Our level of professionalism
Our level of professionalism Excellent
Our level of professionalism Good
Our level of professionalism Adequate
Our level of professionalism Poor
Our level of professionalism Unacceptable
Our level of professionalism N/A
Timeliness of our response
Timeliness of our response Excellent
Timeliness of our response Good
Timeliness of our response Adequate
Timeliness of our response Poor
Timeliness of our response Unacceptable
Timeliness of our response N/A
*
2
. Overall, how do you rate the quality of services we provide?
Overall, how do you rate the quality of services we provide?
Excellent
Good
Adequate
Poor
Unacceptable
*
3
. What level of confidence do you have in our ability to protect you and your family?
What level of confidence do you have in our ability to protect you and your family?
Complete
A lot
Some
Little
None
*
4
. What is your level of confidence in our departments ability to prevent emergencies within our community?
What is your level of confidence in our departments ability to prevent emergencies within our community?
I feel that most emergencies are preventable; however, I do not feel the fire department does enough towards prevention
I feel that most emergencies are preventable and your department works hard to prevent them from happening
I do not see any obvious signs your department does anything to prevent emergencies from happening
I feel like your department works to prevent emergencies; however, most emergencies are unavoidable.
*
5
. Based on our performance and your perception, how do you feel our department compares to other fire departments you have had interaction with?
Based on our performance and your perception, how do you feel our department compares to other fire departments you have had interaction with?
About the same
Not as professional or knowledgable
Much more professional and knowledgable
Not really sure
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6
. What services did you receive?
What services did you receive?
Fire Department and Emergency Medical Services
Fire Department Only
Emergency Medical Services Only
Administrative Services
7
. Please provide questions or comments that you feel will help us improve our department.
Please provide questions or comments that you feel will help us improve our department.
*
8
. Please provide your State, Zip Code and Country for tracking purposes.
Please provide your State, Zip Code and Country for tracking purposes.
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
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