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: