First Responder Health Awareness Survey Form
Help us understand first responder health awareness, habits, and support needs. Your responses are anonymous and will inform wellness initiatives.
Which best describes your primary first responder role?
*
Please Select
Firefighter
Paramedic/EMT
Police Officer
Dispatcher
Search & Rescue
Other
What is your typical shift schedule?
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Day shift
Night shift
Rotating shifts
24-hour shifts
Other
On average, how many hours of sleep do you get per 24-hour period?
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Less than 5 hours
5-6 hours
6-7 hours
7-8 hours
More than 8 hours
How would you rate your overall sleep quality?
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1
2
3
4
5
How often do you experience work-related stress?
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Rarely
Sometimes
Often
Almost always
How would you rate your current level of physical activity?
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Very low
1
2
3
4
Very high
5
1 is Very low, 5 is Very high
How often do you eat balanced meals and stay hydrated during your shifts?
*
Rarely
Sometimes
Often
Almost always
Which wellness resources do you currently have access to through your department or employer? (Select all that apply)
*
Peer support
Mental health counseling
Fitness programs
Nutrition guidance
Sleep education
None
Other
How effective do you find the wellness resources available to you?
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Not effective
1
2
3
4
Very effective
5
1 is Not effective, 5 is Very effective
What wellness support topics or resources would you like to see offered or improved?
Submit Survey
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