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Fire & Emergency Medical Services Survey: How Are We Doing?


  1. 1. Step One
  2. 2. Survey Questions
  3. 3. Community Perception Questions
  4. 4. Comments Section
  5. 5. Contact Information
  • Step One

    1. You will be assisting the Chickasha Fire & Emergency Medical Services Department by providing useful information concerning our department and how service to our citizens can be enhanced. When completing this form, it is not necessary that you provide your name or address as anonymous submissions will be accepted, however, the better the information is, the better we will be at providing accolades or addressing situations. When completed, please press the Submit button, or if you prefer, print it out and mail to the address provided at the end of the survey.

    2. Demographic Questions

    3. How long have you lived in the City?*

    4. What is your age?*

    5. What is your gender?*

    6. Have you ever used our services in the past?*