Online Forms

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Provide Feedback to Eugene Springfield Fire

  1. Eugene Springfield Fire Patch

  2. Did you or someone you know recently receive service from Eugene Springfield Fire? If so, please complete this short survey to let us know how we are doing. Your feedback helps us provide the best public service possible! **Please do not include in this form any sensitive information, such as social security numbers, driver’s license numbers, bank account information, or medical information.

  3. Which type of service did you seek from Eugene Springfield Fire?*

  4. If the above options do not describe the type of service you were seeking, please describe the type of service here.

  5. FMO Service Received

    Please select one.

  6. If the above options do not describe the type of service you were seeking, please describe the type of service here.

  7. How would you categorize this feedback?

    Please select one.

  8. Please either provide the address where service was provided or indicate if service was provided via phone, email, fax, or other means.

  9. How would you rate the professionalism of the personnel who provided the service?*

  10. How would you rate the quality of the service you received?*

  11. Was our team able to assist you in your time of need?*

  12. Part of our mission is to solve problems with compassion. Did our team fulfill this part of our mission?*

  13. Would you like a representative from Eugene Springfield Fire to contact you?*

  14. Leave This Blank:

  15. This field is not part of the form submission.