Form Center

2. Fire Survey
4. RESPECT, INTEGRITY, HONOR, DUTY and UNITY
6. Fire Department Satisfaction Survey
   Andover Fire Rescue is committed to providing high quality customer service. Please take a few moments to rate your service experience.
8. Fire Fighter's Name (if known)
10. Date of Incident
11. Time of Incident
12. Incident # (if known)
14. Prior to your most recent contact with Andover Fire Rescue, have you had any previous contact with this department?

    1. Yes
    2. No
16. How many contacts in the past 12 months?
18. In regards to your most recent incident, what was the nature of your contact?
    -- Select One --House FireRubbish FireBrush FireMotor Vehicle AccidentReported a ProblemRequested Information/AssistanceBurn PermitOther
20. Considering this most recent contact, please rate Andover Fire Rescue in the following areas:
22. Fire Fighter's Appearance

    1. Excellent
    2. Good
    3. Fair
    4. Poor
23. Fire Fighter's Professional Conduct

    1. Excellent
    2. Good
    3. Fair
    4. Poor
25. Fire Fighter's Concern (Compassion)

    1. Excellent
    2. Good
    3. Fair
    4. Poor
26. Fire Fighter's Ability to Put You at Ease

    1. Excellent
    2. Good
    3. Fair
    4. Poor
28. Fire Fighter's Knowledge

    1. Excellent
    2. Good
    3. Fair
    4. Poor
29. Fire Fighter's Response Time (if applicable)

    1. Excellent
    2. Good
    3. Fair
    4. Poor
31. Fire Fighter's Helpfulness

    1. Excellent
    2. Good
    3. Fair
    4. Poor
33. Please check all that apply

    1. Provided quick extinguishment
    2. Protected undamaged property
    3. Prevented further damage
    4. Prompt investigation
    5. Provided full explanation of the investigation
    6. Provided resources to aid in recovery
35. On a 1 to 10 scale, please indicate your overall satisfaction with Andover Fire Rescue
    -- Select One --10 Excellent98 Good765 Fair43 Poor21 Very Poor
37. How can Andover Fire Rescue improve the quality of its service in the future?
39. Would you like to leave any additional comments?

    1. Yes
    2. No
41. Additional Comments:
43. Would you like to be contacted?

    1. Yes
    2. No
45. Your information (Optional)
47. Name
48. Address
49. Phone
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

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