Community Satisfaction Survey – City of Colton Fire Department

Date of Contact: *

Type of Interaction *

Other Type (if applicable):

Please rate the following from 1 to 4.

(4 = Excellent, 1 = Poor, N/A = Not applicable)

Fire Department Personnel:

Professionalism: *

Knowledge: *

Courtesy: *

Communication: *

Clarity Interaction Compassion

Appearance: *

Compassion (if applicable): *

Service Experience:

Response Time: *

Clarity of Information: *

Support with Needs: *

Overall Satisfaction: *

Overall Experience:

Were your expectations met? *

Additional Comments:

Optional Contact Info:

Name

First

Last

Phone Number

Would you like to be contacted? *