2. What type of services did you receive from the fire department?*

   1. Fire
   2. Medical
   3. Inspections
   4. Other
4. What date did you receive services from the fire department?*
   What date did you receive services from the fire department?
6. What address did you receive services?
   Identify the intersection or specific address at which you received services from the West Fargo Fire Department.
8. Intersection
10. Address
12. City
13. State
14. Zip Code
16. Was our team able to help you in your time of need?*

    1. Yes
    2. No
18. Part of our mission is to provide services in a professional manner. Was our team professional, courteous, polite and attentive?*

    1. Yes
    2. No
20. Is there anything our team could do better in the future to serve the community?
22. We value any additional feedback you might want to provide.
24. Contact information
    Please provide your name and phone number if you would like someone from the fire department to contact you regarding the services you received from the West Fargo Fire Department.
26. First Name
27. Last Name
29. Phone Number
30. Email Address
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field