Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Request a Free Smoke Alarm


  1. 1. Contact Information
  • Contact Information

    1. Are you the homeowner or renter?*
    2. Does anyone in the home smoke?*
    3. OPTIONAL - Does anyone in your home have a disability?
    4. Questions?

      Contact the Fire Marshal's Office at (540)853-2795 or [email protected]

    5. Remember - check your smoke alarms once a month & practice your home fire escape plan!
    6. Leave This Blank:

    7. This field is not part of the form submission.