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 $50.00 fee per incident request for either paper copies or digital copies. This fee is payable upon delivery.

-Adobe - Download Here
-Word- Download Here