JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Customer Satisfaction Survey: Incidents, Calls For Service, Emergency Responses
Ross Valley Fire Department Customer Satisfaction Survey for public interactions with fire department personnel during calls for service, and emergency responses.
Sign in to Google
to save your progress.
Learn more
Date
Date of Incident, Call For Service, or Emergency Response
MM
/
DD
/
YYYY
Address
Address or Location of Incident, Call For Service, or Emergency Response
Your answer
Your Full Name
Your answer
Your Email
If you request a response or follow up, your email address is required.
Your answer
Fire Department personnel responded promptly.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Fire Department personnel solved the issue that prompted the request for service.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Fire Department personnel were courteous and helpful.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Fire Department personnel took time to explain their actions.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Fire Department personnel were professional in appearance.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Overall I was satisfied with the Department's service.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
What Type of Service Did the Fire Department Provide?
Emergency Medical Aid
Public Service Assistance
Fire Alarm
Fire Suppression
Rescue
Property Protection (flood, storm damage, etc)
Other
Clear selection
Comments, Questions, Concerns
Note - Fire Department personnel can only respond to comments and questions if you provide contact information, above.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of RVFD.
Report Abuse
Forms
