Required fields are marked with asterisks (*)

Online Home Safety Check Registration

Use this form to submit your request directly to Port Moody Fire Rescue. Once we have processed your request, you will be contacted to arrange a visit by fire service personnel. If you have any difficulty with the form, please call 604.469.7795

About you:

Best time to schedule an inspection:
 

About the residents:

How many people live in the home?
How many residents are seniors?
How many residents are children?
Are any residents disabled?

About the home:

Type of Home:
Do you have a working smoke alarm?
Do you have any safety concerns right now?

All households will be required to sign a waiver prior to the inspection. Before submitting please review this information and this waiver form.*

I have read and agree to the waiver