Request Forms

These forms below are for various uses.. The forms can be downloaded as a Microsoft Word fill - in form or in Adobe Acrobat™ to be viewed and printed. If needed, Adobe Acrobat Reader™ can be downloaded here. After printing and entering the information, send the completed forms via one of the methods below:

Fax to: 304-659-3772
OR
Mail to our location at: Central Communications, Inc. P.O. Box 516, Pennsboro, WV 26415
OR
Email to : cci@centrale911.com

 

Forms for Public Use

Form for request to enter location alert for medical history.

Central Communications Inc. provides the ability for a medical alert for those with life threatening or mobile disability conditions, to be displayed to our Telecommunicators upon receipt of a 911 call from the residence.

-Adobe - Download Here
-Word- Download Here

 

 

Form for request to enter Keyholder Information for Security/Fire Alarms.

Please provide accurate information on Keyholders to notify in case of activation of Security, Panic or Fire Alarms at your residence or business.

-Adobe - Download Here
-Word- Download Here

 

 

Form for request of recordings of 911 calls or radio traffic.

Central Communications Inc., (CCI) will provide, with WV FoIA request or proper subpoena from a Court of Law, radio and/or telephone recordings and/or text call information of incidences. Requests that include personal medical information or law enforcement information will also need to be approved by the Prosecuting Attorney from each respective County, and CCI will require a subpoena from a Court of Law. CCI will not be responsible for this information once it has left the custody of CCI. Requesting agency/person will be charged a $25.00 fee per incident request, payable upon delivery.

-Adobe - Download Here
-Word- Download Here


 

Forms for LE/Fire/EMS Agencies Use

Central Communications Inc., (CCI) will provide radio and/or telephone recordings to agencies that it serves on a regular basis, for purpose of internal investigative and/or personnel issues only. Once the information is turned over to said agency it is the sole responsibility of the requesting agency to ensure that the information is used only for the purposes of internal investigative/personnel issues. CCI will not be responsible for this information once it has left the CCI facility. Requesting agency agrees to provide a replacement CD-R, or if they wish, provide a supply of CDR's for CCI to record the agency's events.

Form for request of 911 Calls or Radio Traffic (Fire/EMS)


-Adobe- Download Here
-Word- Download Here

Form for request of 911 Calls or Radio Traffic (Law Enforcement)
-Adobe- DownloadHere
-Word- Download Here

Forms for Issue Resolution (problems with Calls
-Adobe- Download Here
-Word- Download Here

Copyright © 2018 Central Communications, Inc. | Updated September 5, 2018