User Agency Radio Trouble Report

Fields marked with are required

Problem date
Problem time	(Use 13:00 for 1:00pm, etc)
Channel
Description of problem (Check all that apply)	Could not hear dispatcher Could not hear other cars/units (describe below) Dispatcher could not hear me Skip/static/strange noises Fire/EMS tone did not activate Other problem (describe below)
Additional problem description	0 / 250 Further description of problem is required
Location description	Please describe location in detail, especially if inside building 0 / 250
Car/vehicle/apparatus number
Portable number
Radio model
Name of reporting party
Department of reporting party
Contact phone number
Contact email address