Enter your Agency/PSAP Name in the space provided below.

Choose one of the following options:
 Primary PSAP
 Secondary PSAP

County Name:

PSAP Director/Manager:

Please provide the following contact information for the PSAP Director/Manager:

Number of Full-time Employees?

Number of Part-time Employees:

Number of Employees per shift:

Number of Dispatchers per shift

Hours of Operation: (e.g. 24x7x365 or ?):

Is 9-1-1 Service Provided?
 Yes     No

If yes:
Select... Enhanced 9-1-1 Basic 9-1-1

Number of dispatch consoles available:

Service provided for what types of Agencies. (Select all that apply):
 Police  Fire  EMS Sheriff  State Government  Other

If "other", list here:

Type of CAD System Used:

List MDTs/MCTs used for Silent Dispatch:

List type of Unit Tracking or AVL System: 

Type of GIS (computer mapping) Program Used:

Type of Phone System Used (e.g. CML, Positron, Plant, etc.)

Type/Brand of Radio System Used:

Do you use EMD? 
 Yes    No

If yes, what type of EMD is used (e.g. Medical Priority, APCO, Power Phone, etc.):

If yes, what type of program is used?
 Computer EMD Program    Standard Card Sets      Other                 

Does Agency utilize TCIC/NCIC?
Select... Yes No

If yes, what modules are staff certified in?

Do you feel you could provide a TEAM to assist other Communication Centers in the event of an emergency?
Select... Yes No

If yes, how many could you deploy at once? 

Do you use 10 codes or common language? 
Select... 10 Codes Common Language Combination

Do you service agencies other than your own? If so, list here. 

What is your chain of command structure?

Do you have an Emergency Operations Plan in effect? 
  Yes   No

Please provide the contact information for person who is in ultimate control of the PSAP (city/county manager, sheriff, police chief, etc.)

Use this space to add any additional information you wish to share.