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