Citizen Call Survey

Date of Call:

Time of Incident (Approx):

:

Type of Call

Were you transferred to another agency?

Responding Agency:

Incident/Case#:

Please answer the following:

1. When you called 9-1-1, was your call answered promptly?

Rating Scale: 5-Exceptional…1-Poor

2. Do you feel the 9-1-1 Call Taker was knowledgeable?

Rating Scale: 5-Exceptional…1-Poor

3. Do you feel your call was handled in a professional manner?

Rating Scale: 5-Exceptional…1-Poor

4. Was the 9-1-1 Call Taker courteous and helpful?

Rating Scale: 5-Exceptional…1-Poor

5. Did the 9-1-1 Call Taker understand your needs?

Rating Scale: 5-Exceptional…1-Poor

6. Do you believe the Call Taker asked the appropriate questions?

Rating Scale: 5-Exceptional…1-Poor

7. Overall, how would you rate the 9-1-1 service you received?

Rating Scale: 5-Exceptional…1-Poor

Please list any other comments or suggestions:

Would you like contact regarding this incident?

If yes, please list your name and contact information:

Name, Phone Number, Email Address, Etc.