Contact Information

Home Phone:  
First Name:   Last Name:  
Email Address:
Address:  
City:  State:  Zip:  
Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin

Call Information

Service Requested: Law EnforcementFireEMSOther
Date Service Requested (mm/dd/yyyy):   Time:   AMPM  
Incident/Case Number (if known):
The phone number called from:  

Survey Questions

Do you feel the phone was answered in a timely manner?

YesNo

Was the Telecommunicator polite and courteous while speaking with you?

YesNo

If you had an emergency call, how would you rate the telecommunicator's ability to remain calm, handle the emergency and put you at ease?

ExcellentGoodFairPoor

Due to high call volume, it is sometimes necessary to put a non-emergency call on hold. If the Telecommunicator put you on hold, approximately how long did you wait for them to come back on the line?

0-1 minutes1-3 minutes3-5 minutesMore than 5 Minutes

If you were placed on hold, did the Telecommunicator explain to you, upon returning, why you were asked to hold?

YesNo

If you requested information, was the information you were given helpful in solving your situation?

YesNo

How would you rate the Telecommunicator's knowledge as it pertained to your situation?

ExcellentGoodFairPoor

Do you feel the Telecommunicator was actually listening to you during the call?

YesNo

Did the Telecommunicator explain to you what action the Law Enforcement/Fire Department/EMS would take?

YesNo

Overall, how would rate the service that you received from the Guilford Metro 911, Emergency Communications Division?

ExcellentGoodFairPoor

Do you have any additional comments that you would like to make regarding your contact with the Guilford Metro 911, Emergency Communications Division?