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2. Have you had contact with the Fire Department in the past?

   1. Yes
   2. No
4. If yes, choose all that apply

   1. Medical Services
   2. Fire Suppression
   3. Public Education
   4. Community Risk Reduction
   5. Inspection
   6. Hazardous Materials
   7. Rescue (Technical, ice, water, vehicle)
6. How important are the following services from most important (1) to least important (5)
8. Medical Services

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
9. Fire Suppression

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
10. Public Education

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
11. Community Risk Reduction

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
13. Inspections

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
14. Hazardous Materials

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
15. Rescue (Technical, ice, water, vehicle)

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
17. What service would you like to see improvement in?

    1. EMS (Emergency and non-emergency transfers, standbys)
    2. Fire Suppression (Extinguishment of building fires, vehicle fires, outdoor fires)
    3. Public Education (Station tour, school visit, smoke detector installs, fire extinguisher training)
    4. Community Risk Reduction (Proactively reduce or prevent the impact of incidents)
    5. Inspections (Business inspections, home inspections)
    6. Hazardous Materials (Fluid spills on roadways/waterways, CO incidents, gas leaks, explosive devices)
    7. Rescue (High/low angle, trench, ice, water, vehicle extrication, confined space)
19. What would you consider a reasonable response time from the Fire Department?
21. Are you aware of the Smart911 program?

    1. Yes
    2. No
23. If yes, are you subscribed in Smart911?

    1. Yes
    2. No
25. Are you aware of the Dubuque Fire Department's smoke detector install program?

    1. Yes
    2. No
27. If yes, has the Dubuque Fire Department installed a smoke detector at your residence?

    1. Yes
    2. No
29. Have you participated in a Dubuque Fire Department hands-only CPR demonstration?

    1. Yes
    2. No
31. If yes, where was the demonstration held?
33. How do you rate the service provided by the Fire Department?

    1. Excellent
    2. Good
    3. Fair
    4. Poor
35. How can the Fire Department better meet your needs? Please provide any questions, comments or concerns.
37. Would you like a member of the Fire Department to contact you?

    1. Yes
    2. No
39. First and Last Name
40. Phone Number
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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

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