Peer Support Survey Employee Name Contact Preference(s): Phone Text Email Phone ## For TextsEmail Address What types of cases are bothersome/triggering to you where you’d like someone to reach out to you after:(select any that apply or feel free to write in types of situations that bother you) Cases involving children Violent Domestics (with serious injury/death) Suicide Gunshot Wounds CRED cases Officer involved cases (OIS, ASLO, accidents, etc.) Rescue/Fire Responder (Injured or Line of Duty Death) Rescue Calls Stabbings Accident Fatalities Elderly Callers / Disabled Callers (Violent or Fatalities) Irate/ Difficult Callers Other: Rescue Calls Addt'l Info OtherdescribeIf there is a specific person(s) on the Peer Support Team you would prefer to contact you, please list their names: