Feedback Form

  • This form is to be used to register feedback related to the service provided by the Winnipeg Fire Paramedic Service.
  • All information is confidential and will be used for internal purposes only.
Feedback Type* Thank a WFPS Member
Submit a Concern
First Name*
Last Name *
Mailing Address*
Email Address *
Confirm Email Address *
Patient Name (if different from above)
Invoice Number (If Applicable)
Customer ID (If Applicable)
Relationship to Patient (If Applicable)
Incident Type * EMS Call
Fire Response
Fire Inspection
Public Education
Other (Please specify in comments)
Date and Time of Incident*
Location of Incident
Incident Details/Comments
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