| Date of 911 Call? |
Approximate time of call?
|
| Address where the emergency occurred? |
|
| Type of Emergency |
|
| 1. What Type of Assistance were you requesting? |
Police
Fire
Medical |
| 2. Were you calling from a wireless (cellular) phone? |
Yes
No |
| 3. How many rings did it take to answer your phone |
1-3
4-6
7-9
more than 10 Rings
Unknown |
| 4. Did the 9-1-1 Operator understand your request/situation |
Yes
No |
| If no, please explain |
|
| 5. Did the 9-1-1 Operator transfer you to the correct agency: |
Yes
No |
| If no, please explain |
|
| If you did not require police, fire, or medical assistance, did the 9-1-1 Operator
offer another solution to resolve your situation? |
Yes
No |
| If no, please explain |
|
| How would you rate the Operator’s listening skills? |
1
2
3
4
5 |
| If 1 or 2, please explain |
|
| How helpful or informative was the 9-1-1 Operator? |
1
2
3
4
5 |
| If 1 or 2, please explain |
|
| How polite and courteous was the 9-1-1 Operator? |
1
2
3
4
5 |
| If 1 or 2, please explain |
|
| Overall, please rate the service you received from the 9-1-1 Operator? |
1
2
3
4
5 |
| Additional Comments |
|
|
|
|
|