Omaha Fire Department Free Smoke/Carbon Monoxide Detector Program Smoke Detector Installation Request Form

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Omaha Fire Department Free Smoke/Carbon Monoxide Detector Program Smoke Detector Installation Request Form Smoke Detectors save lives! Are you prepared? Is your family safe? Omaha Fire Department Free Smoke/Carbon Monoxide Detector Program The Omaha Fire Department installs smoke/Carbon Monoxide detectors for homeowners in Omaha, free of charge! Detectors for individuals who are deaf or hard of hearing! Smoke/Carbon Monoxide detectors are also available for individuals who are deaf or hard of hearing, free of charge! These special detectors utilize flashes of light and bed shakers, in addition to sounding an audible alarm, and are essential for individuals who are deaf, hard of hearing, or those who may wear hearing aids during the day but take them off to sleep. Your family's safety is important to us! If you are in need of a smoke/Carbon Monoxide detector for your home, would like to request an inspection, or just not sure if you have the right protection, please do not hesitate to contact us! Your family's safety is our top priority! Schedule your free installation today! Please complete the information below and mail your completed form to Omaha Fire Department Public Education Office, 1606 South 50 Street, Omaha, NE 68132 – you can also schedule an installation by calling 402-444-3560 or by texting 402-718-2976. Completed forms may also be emailed to [email protected]. Name ________________________________________________________________________________ Address ______________________________________________________________________________ Phone Number _____________________ Email ____________________________________________ How many floors/levels in the home? ___________ How many people in the home? _________________ Comments ____________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Please circle all that apply: Detector Check Detector Installation Deaf/Hard of Hearing Detectors.

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Smoke Detectors Carry a Small Amount of a Radioactive Isotope Called Americum 241
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