We are constantly seeking ways to improve service to our customers. If you have received assistance from the Santa Clara Fire Department, we ask that you evaluate our level of service. Please take a minute to provide some feedback by completing the following survey. Any additional comments you may have can be submitted below, or by sending an email to Fire@SantaClaraCA.gov

Our mission is to provide the best possible service to all customers at every opportunity.

1

What contact did you have with the Santa Clara Fire Department?

 *

What contact did you have with the Santa Clara Fire Department?

Fire/Smoke

Medical Aid

Public Service

Other (Please Specify) If other, type text here.

2

At

At

Address/location:

Time:

Date:

3

 

	Strongly Agree	Agree	Disagree	Strongly Disagree	Not Applicable
The Fire Department responded promptly.	Answer	Answer	Answer	Answer	Answer
Fire Department personnel were courteous.	Answer	Answer	Answer	Answer	Answer
Fire Department personnel were helpful.	Answer	Answer	Answer	Answer	Answer
Fire Department personnel were professional in appearance.	Answer	Answer	Answer	Answer	Answer
Overall, I was satisfied with the Fire Department's service.	Answer	Answer	Answer	Answer	Answer
I was satisfied with the ambulance service.	Answer	Answer	Answer	Answer	Answer

4

If you would like to provide additional comments, or suggestions for fire service improvements, please do so:

If you would like to provide additional comments, or suggestions for fire service improvements, please do so:

5

The men and women of the Santa Clara Fire Department take pride in providing the highest level of service possible to our citizens. Our motto is "Service Without Limits" and your opinion of our customer service matters. Please feel free to call (408) 615-4900 if you have comments that would help us to improve our service in the future.

I would like to speak to a Fire Department representative:

The men and women of the Santa Clara Fire Department take pride in providing the highest level of service possible to our citizens. Our motto is "Service Without Limits" and your opinion of our customer service matters. Please feel free to call (408) 615-4900 if you have comments that would help us to improve our service in the future. I would like to speak to a Fire Department representative:

Yes

No

Name:

Phone:

Best time to call:

AM

PM

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