El Paso/Teller County E911
Field EMD Responder Form

This form is a tool for evaluating the efficiency, accuracy, and effectiveness of the Priority Dispatch System. Please report exceptional services as well as errors. The data assembled will be utilized in assessing the response to various codes, and for Quality Assurance of the Dispatch system.

Please include as much information as possible in this form.


Fields marked (*) are required.

Full Name:(*)
 E-Mail Address:(*)
Shift:
 Alarm #:
Time and Date of Call:
Address:
 Dispatch Code Given:
Was Code Given Correct?
(Check box if YES):
Situation:
 Comments: