Form Center

2. The Roanoke County Emergency Communications Center wants your assistance to help improve the quality of service we provide. The survey below can be submitted anonymously, or you can provide your contact information if you would like a staff member to follow up on your comments. Information marked (*) is required.
   
   Please note: This is not a complaint form; therefore you will not receive a reply unless you request to be contacted. This form applies only to the Emergency Communications Center's handling of your call.
4. Date of Call*
   Date of Call
5. Time of Call*
   Time of Call
7. What telephone number did you call?*
   -- Select One --9-1-1(540) 562-3265
9. Please select the answers below that reflects your experience when calling the Emergency Communications Center.
11. When I called I received a busy signal.
    -- Select One --YesNo
13. My call answered in a timely manner.
    -- Select One --YesNo
15. The call taker responded in a professional manner.
    -- Select One --YesNo
17. The call taker was courteous and helpful.
    -- Select One --YesNo
19. The call taker was knowledgeable and confident.
    -- Select One --YesNo
21. The call taker answered my questions or directed me to someone who could.
    -- Select One --YesNo
23. I was notified of any significant delay in anticipated police, fire, or rescue response times.
    -- Select One --YesNo
25. Please indicate the overall quality of service received.
    -- Select One --ExcellentGoodAverageFairPoor
27. May we contact you to discuss your comments further?
    -- Select One --YesNo
29. Name (optional)
30. Phone Number (optional)
32. Email Address (optional)
34. Additional Comments, Questions or Suggestions:
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field