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Minnesota State Fire Department Association
 
 
 
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MINNESOTA FIREFIGHTER CANCER DATABASE

The Association is building a database of Minnesota firefighter cancer occurrences to include specific demographics and rates of cancer among our members. This data is key in providing better benefits and enacting laws to protect members. We are asking Minnesota firefighters to voluntarily help build information on this tragic disease. If you have any type of cancer, or are a survivor, and are a career or volunteer/paid-on-call firefighter in Minnesota, we need your help. Please take five minutes to complete the following questionnaire. The database does not contain identifying information of the contributors.

Information requested in this survey is to assist with advancement and improvement of Minnesota First Responder health and safety programs, services, resources and legislation. Information received is confidential and any public reporting of statistics gathered will represent general trending.

Are you now or have you ever been:
If you are or were a volunteer what was your primary occupation?
*
How many years of service?
*
Your current age:
Please provide an estimate of the average number of fire calls per year you responded to during your time as a firefighter:
*
Does (did) your fire department provide annual physicals?
Did you receive a pre-employment physical?
Was your cancer found as a result of one of these physicals?
Does (did) your fire department provide fitness programs or equipment for your use?
Please classify the type(s) of cancer which you have
Your current status:
* indicates a required field
Please fill this field.
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