Injury Prevention and Retention Survey

Please complete this survey to the best of your ability. All responses are anonymous.
What region do you serve?

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* 1. What region do you serve?

Type of service:

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* 2. Type of service:

Responder type (Choose your most frequent response type):

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

How many years have you served as a first responder?

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

Has an injury, illness, or stress from work caused you loss of sleep or other impairment?

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

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