PSAP Name:
Physical Address:
Director/Manager:
Telephone:
Primary Contact:
Secondary Contact:
Telephone:
24x7 Number:
CPE Manufacturer:
CPE Model:
CAD Manufacturer:
CAD Model:
Mapping Manufacturer:
Mapping Model:
Radio System Manufacturer:
Radio System Description:
Emergency Medical Dispatch Program (EMD):
EMD Version:
Mobile Data Computer Manufacturer (MDC):
MDC Model or Version:
Participating In TERT Deployments: Yes
No
Participating in MEMAC Yes
No

Staffing Types:

Call Takers Only (Select Discipline) Law Enforcement
Fire
EMS
Public Safety (All 3 Disciplines)
Radio Dispatchers Only (Select Discipline) Law Enforcement
Fire
EMS
Public Safety (All 3 Disciplines)
Telecommunicator (Both call taker & Radion Dispatcher) Law Enforcement
Fire
EMS
Public Safety (All 3 Disciplines)
Shift Length: 8
10
12
Other

Number of Positions:

Call Takers
Radio
Telecommunications
Other
Please list all the law enforcement agencies you serve:
Please list all the Fire agencies you serve:
Please list all the EMS agencies you serve:

 

Form provided by Freedback.

 

Powered by liveSite Get your free site!