Worcester County Fire Marshal's Office Online Referral Form

Please use this form to submit non-emergency related complaints to our office. Items of extreme urgency should be directed using the following telephone numbers:

• Worcester County Fire Marshal's Office
  410.632.5666
  (During normal business hours: Mon-Fri, 08:00 - 4:30)
   

• Worcester County Emergency Services - Dispatch Center
  410.632.1311
  (After Hours, Weekends and on County Holidays)

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REFERRAL LOCATION
Building Name:
Address:
Unit #:
City:
In an Incorporated Town:		Select One Yes No
Occupancy Type:		Select One Residential Commercial
Type of Complaint:		Select One or More Fire Alarm System Deficiency Sprinkler System Deficiency Fire Pump Deficiency Smoke Alarm Deficiency Standpipe System Deficiency Smoke Evacuation System Deficiency Electrical System Deficiency No Smoke Alarms Present / Not Working Improper Storage of Hazardous Materials Fire Department Connection Blocked / Obstructed Fire Lanes Blocked / Obstructed Fire Hydrant Blocked / Obstructed Fire Exit Blocked / Obstructed Lack of Emergency Contact Numbers No Posted Building Name or Address Other (Explain Below)
Other Complaint Type:
Date of Incident:
Time of Incident:
Reoccurring Situation:		Select One Yes No Unknown
PERSON / AGENCY MAKING REFERRAL
Type:		Select One County Fire Department Dispatch Center County / Local Resident
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Fire Department Name (FD Only):
Run Number (FD Only):
Additional Comments:
Do you wish to be contacted?		Select One Yes No Remain Anonymous

* Bold Denotes Required Fields

 

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