El Paso-Teller County E-911
Special Request Form

This form is a tool for requesting information about the efficiency, accuracy, and effectiveness of the Priority Dispatch System as it relates to local call takers and dispatchers. 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 detailed information as possible in this form.


Fields marked (*) are required.

Full Name: (*)


E-Mail Address: (*)


Date: (*)


Time: (*)


Address: (*)


Dispatch Given: (*)


Pod # (CSPD ONLY):


Protocol Used: (*)
POLICE    FIRE    MEDICAL

"Tell me exactly what happened...": (*)


"How old is s/he?": (*)


"Is s/he awake (conscious)?": (*)
Yes    No   

"Is s/he breathing?": (*)
Yes    No   

Situation:


Comments:


   


ALL COMMENTS WILL BE RETURNED TO PSAP MANAGER OR REQUESTING SUPERVISOR AS A WORK PRODUCT.

No comments will be returned directly to the call taker or dispatcher without Supervisor or Manager approval.