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2. Please select the type of service you are offering feedback about:

   1. Response
   2. Planning/Training
   3. Alert & Notification

   1. Incident Recovery
   2. Routine Business
   3. Other (if other please describe below)
4. Please provide the following information:
6. Name*
8. Phone Number*
10. Email Address*
12. Do you have any suggestions on how we can improve our service:*
14. Do you have any other comments?
16. The EM staff was professional:*

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
18. The EM staff was kind and courteous*

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
20. The EM staff was knowledgeable and helpful.*

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
22. The EM response was appropriate for the type. of incident*

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
24. Would you like someone to contact you for follow up? If so, make sure you listed a phone number or email at the top of this form. *

    1. Yes
    2. No
26. Thank you for your response to our survey. Town of Bow Emergency Management
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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