Feedback Submission Form

Marion County Emergency Services is committed to providing courteous, responsive, and efficient service. Therefore, it is a standard of practice of this agency to accept and thoroughly investigate all feedback. This process has four goals: To compliment the employee when given positive feedback, to update procedures if needed as a result of this investigation, to correct improper employee conduct, and to protect the employee from unwarranted criticism when their actions were lawful and justified. You can be assured that your feedback will be given our full and compete attention, and if appropriate, you will be notified with the results. Thank you for taking the time to respond and help ensure quality service to Marion County. Please complete all questions on this form. Click on Submit when ready to send.

Date if Incident:
Time of Incident:

Incident or Run Number (if known):
Address of Incident (if known):
Responding Agency:

Description of Incident:

Feedback Information:

The following information is required in order to process the request:

Your Name:
Your E-Mail Address:

Your Phone Number:
Your Full Mailing Address:



Prefer to complete this by mail?


Click here to download a paper copy of this form.