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* 1. Based on what you know today, how do you believe the Waupun Fire Department is staffed?

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* 2. Based on what you know today, how  do you believe ambulance service is provided in the City of Waupun?     ( Check all that Apply)

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* 3. On a scale of 1 to 5 with 5 being very important and 1 being not important, please rate the following services provided by the Waupun Fire Department

  Not at all Important Very Important
Fire Inspection/Code Enforcement
Fire Investigation/Cause Determination
Community Risk Reduction ( Health and Safety Education)
911 Fire Response
911 Emergency Medical Response
Vehicle Extraction (Jaws of Life)
Technical Rescue ( Water, Confined Space, Rope, etc.)
Emergency Management (response and preparedness for local disasters)

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* 4. If you had to call 911 for a fire on your home, how long do you believe you should wait for the fire department to arrive?

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* 5. If you or a loved one were having a medical emergency and you called 911, how long do you believe you should wait for an ambulance to arrive?

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* 6. What level of Emergency Medical Care do you expect when you call 911 for an ambulance?

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* 7. If staffing levels needed to change to ensure emergency response, would you be willing to pay additional taxes to support that need?

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* 8. On a scale of 1-5 with 5 being very confident and 1 being not confident at all, how confident are you that the Waupun Fire Department is prepared to meet your emergency response needs?

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* 9. On a scale of 1 to 5 with 5 being very satisfied and 1 being not satisfied at all, how satisfied are you with the services provided by the Waupun Fire Department?

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* 10. Please provide any additional comments about emergency response services in Waupun that you feel are important to the future of the Waupun Fire Department.

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* 11. My home address is located in:

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