Southern Region EMS Council Inc.

Injury Prevention and Retention Survey

Please complete this survey to the best of your ability. All responses are anonymous.

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1. What region do you serve?

Alaska, Southern

Alaska, Southeast

Alaska, Yukon-Kuskokwim

Alaska, North Slope

Alaska, Interior

Alaska, Maniilaq

Alaska, Norton Sound

Other (please specify)

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2. Type of service:

Volunteer municipal or borough

Volunteer non-incorporated

Municipal or borough

Other paid EMS

Other (please specify)

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3. Responder type (Choose your most frequent response type):

Firefighter

Law Enforcement

Emergency Medical Services

Clinic

Other (please specify)

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4. How many years have you served as a first responder?

0-1

2-3

3-5

5-10

10+

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5. Has an injury, illness, or stress from work caused you loss of sleep or other impairment? (Required.)

Yes

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* 1. What region do you serve?

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* 2. Type of service:

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* 3. Responder type (Choose your most frequent response type):

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* 4. How many years have you served as a first responder?

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* 5. Has an injury, illness, or stress from work caused you loss of sleep or other impairment? (Required.)

1. What region do you serve?

2. Type of service:

3. Responder type (Choose your most frequent response type):

4. How many years have you served as a first responder?

5. Has an injury, illness, or stress from work caused you loss of sleep or other impairment? (Required.)