Smoke Alarm Installation Survey

2. Do you feel your request for an inspection was answered promptly?
   *
   -- Select One --YesNoUndecided

4. Were the firefighter/EMTs who came to inspect your smoke alarm(s) courteous and professional?
   *
   -- Select One --YesNoUndecided

6. Did the firefighter/EMTs provide you with information regarding the operation and regular testing of your smoke alarm(s)?
   *
   -- Select One --YesNoUndecided

8. Do you have any additional questions that were not answered at the time of our visit?

10. Additional Information/Comments:

12. Date of Inspection:
    

14. How would you rate our overall customer service?
    *

    1. Very Satisfied
    2. Satisfied
    3. Fair
    4. Unsatisfied
    5. Very Unsatisfied

16. Age of your home:
    

18. Type of home:
    *

    1. Single Family
    2. Townhouse
    3. Condo/Apartment
    4. Other

20. Number of Occupants in each age category living in your home:

22. 0-5 Years

24. 6-12 Years

26. 13-17 Years

28. 18-54 Years

30. Over 55 Years

Leave This Blank:


32. Submit

* indicates a required field