Forms • Fire Department Customer Survey

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Fire Department Customer Survey

Leave This Blank:

What contact did you have with the Port Angeles Fire Department? *

	Fire/Smoke
	Medical Aid

	Public Service
	Other

Name*

Phone Number *

Address/Location *

Date*

Time*

The Fire Department responded promptly*

	Strongly Disagree
	Not Applicable

Fire Department personnel were courteous*

	Strongly Disagree
	Not Applicable

Fire Department personnel were professional in apperance*

	Strongly Disagree
	Not Applicable

Overall, I was satisfied with the Fire Department's Service*

	Strongly Disagree
	Not Applicable

If you would like to provide additional comments, or suggestions for fire service improvements, please do so

I would like a personal response from a Fire Department representative

Yes

* indicates required fields.

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