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

   1. Medical Emergency
   2. Routine Business

   1. Fire Emergency
   2. Fire Prevention / Inspections
4. Please provide the following information:
6. Name*
8. Email*
10. Phone
12. Do you have any suggestions on how we can improve our service?
14. Do you have any other comments?
16. The employee(s) were professional.

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
18. The employee(s) were kind and courteous.

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
20. The employees(s) were knowledgeable.

    1. No Selection
    2. Strongly Disagree
    3. Disagree
    4. Agree
    5. Strongly Agree
22. The Bow Fire Rescue response was fast enough.

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

    1. No Selection
    2. Yes
    3. No
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field