FIRE & EMS Documentation Form
This form is to be used to document events that occur within the county to be maintained as a database.
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Name *
Email: *
Contact number: *
Name of Department *
Type of Department? *
Rank: *
Type of event: *
Description *
Was the issue reported to the responsible agency/party? *
Date when reported?
Agency and name of person reported to?
Has the issue been resolved? *
Needs follow-up? (describe below)
Level of Seriousness? *
Frequency of the Issue? *
Describe if you selected 'Continual Issue' in the previous question:
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