Contacting Team Member(s) – Fauquier County Peer Support Team

Form Instructions

Use this form when contacting team member(s) of the Fauquier Fire Rescue Peer Support Team. You may submit a form completely anonymously or include your contact information. The Peer Support Team takes confidentiality very seriously. Read about our confidentiality policy and exceptions to this policy.

**This form is not designed to handle emergency communications**

If this is an emergency please instead dial 9-1-1 or 9-8-8 for the Suicide & Crisis Lifeline.
More information about the Suicide & Crisis Lifeline can be found here.

Who do you wish to contact?

Check all that apply to your request. Selecting "All Team Members" will send your form submission to all the team members regardless of other selections.

Do you wish to remain anonymous?

Yes
No

you of Who

Your Name

First

Last

Your E-mail Address

Your Phone Number

Do you require a phone call or e-mail back?

Please Call Me
Please Email Me
No Contact Required

We will use this as the primary communication to reach out to you if requested. If we cannot reach you by the primary request, we may attempt the alternatives.

Details of your request or reason for contact

You can be as detailed as you wish a member or member(s) of our team will receive and process your request and if indicated reach back out to you. This form is designed for reporting anonymously, if you selected anonymously we will not be able to reach out to you directly if you have not included your contact information.