Hendricks County Communications Center - Concern or Compliment

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* 1. Full Name and Contact Info:

First Name:

Last Name:

Email Address:

Phone Number:

Home Address / City / State / Zipcode:

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* 2. Type of Incident:

EMS (Medical Call)

Fire

Police:

Other (please specify)

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* 3. Details of the Incident:

Location of Incident:

Date of Call:

Time of Call:

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* 4. Regarding the 911 Service - Please state any Concerns, Compliments, Recommendations, or Suggestions for Improvement:

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* 5. All statements and information provided in this complaint/compliment are truthful and accurate to the best of your knowledge and abilities:

Agreed