Forms Module

2. Smoke Alarm Request

   The members of the Charleston Fire Department would like to assist you in making your home as safe as possible. Free smoke alarms and alarm batteries are available for installation by CFD members in residential homes located in the City of Charleston.  Please complete the form below to request assistance. 

   If you are not sure if you are within the city, use GIS Interactive Map to check your address.  If you do not reside within the City of Charleston please contact your local fire department to inquire about their smoke alarm program.

4. Name of person making the request*
5. Relationship to property*
   -- Select One --Home ownerResidentFamily memberFriendCaregiverOther
7. Name of primary resident*
8. Phone Number*
10. Address*
11. Email*
    Email that you can be reached at.
13. Do you live within the City of Charleston?*
    -- Select One --Yes - Please continue completing this form.No - Please contact your area fire department.

     If you live outside of the City of Charleston, please contact your local fire department to request a smoke alarm or battery.

    
    

14. Preferred installation day and time?
    -- Select One --Monday thru Friday, 5PM - 7PMSaturday or Sunday, 10AM - NoonSaturday or Sunday, 5PM - 7PMI would like to request a different time

    Installation times are generally limited to the options provided.  Special circumstances or scheduled by be considered. 

18. Do you own or rent the property?
    -- Select One --OwnRent
19. As rental property, have you contacted your landlord for assistance?
    -- Select One --Yes, they have not respondedNo, I will contact them

    Please note that if you are renting your home the landlord is required to provide you with a working smoke alarm(s) upon initial move-in and replace defective alarms. It is your responsibility to notify the landlord of missing or defective alarms.

    
    

21. How many floors is your unit or home?
    -- Select One --123
22. How many bedrooms?
    -- Select One --12345+
24. Do you currently have working smoke alarms in the home?
    -- Select One --YesNoI'm not sure
25. What type of existing alarms to you have?
    -- Select One --Battery operated onlyHardwired (household power) onlyHardwired with battery backupI'm not sure

    Please help us understand the the type of alarms you currently have in your home, if any: 

27. Approximately how tall are your ceilings?*
    -- Select One --8'-10' tall (standard)11'-12' tall (raised)13' or taller (high or vaulted)

    Help us plan for the type of ladder and equipment we may need.

29. Are any residents hearing or visually impaired?*
    -- Select One --YesNoI'm not sure
30. How many residents are hearing impaired?
31. How many residents are visually impaired?
35. Children
    How many children reside in the home in each age group?
36. Grades 0-5?
    -- Select One --012345+
37. Grades 6-8?
    -- Select One --012345+
38. Grades 9-12?
    -- Select One --012345+
40. Adults
    How many adults reside in the home in each age group?
41. Adults ages 18-65?
    -- Select One --012345+
42. Adults over 65?
    -- Select One --012345+
44. Please note

    Please note that if you are renting your home the landlord is required to provide you with a working smoke alarm(s) upon initial move-in and replace defective alarms. It is your responsibility to notify the landlord of missing or defective alarms. If you live outside of the City of Charleston, please contact your local fire department to request a smoke alarm or battery.

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46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

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