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PATIENT SURVEY

South Central EMS takes pride in providing you with the utmost professional and sophisticated care. We are always looking for ways to improve our service but we need your help! We want to Thank You in advance for completing this questionnaire. When completed, please be sure to hit submit at the bottom of this page.

INSTRUCTIONS: Please rate the services you received while using our ambulance service. Select the appropriate box that best describes your experience. If a question does not apply to you or is unknown, please skip to the next question. Space is provided for you to comment on positive or negative experiences that may have happened to you.

The person you called for service (Dispatcher)

Helpfulness of the person you called for ambulance service
Concern shown by the person you called for ambulance service
Extent to which you were told what to do until the ambulance arrived

First Responders - If Medical First Responders arrived before the ambulance to assist you,  please answer the following. If no first responders, please go to the next section.

Extent to which the the first responders arrived in a timely manner
Care shown by the first responders
Professionalism of first responders

The Ambulance

Extent to which the ambulance arrived in a timely manner
Cleanliness of the Ambulance
Comfort of the ride

EMS Providers

Care shown by the EMT or Medic who arrived with the ambulance
Degree to which the EMT or Medic listened to you and/and or your family
Skill of the EMT or Medic
Extent to which the EMT or Medic kept you informed about your treatment
Extent to which the EMT or Medic included you in the treatment decisions
Degree to which the EMT or Medic relieved your pain or discomfort
EMT or Medics concern for your privacy
Professionalism of the crew

Overall Assessment

How well did our staff work together to care for you
EMS Crews Professional Apperance
Overall rating of the care provided by our Emergency Transport Service

What could we do better the next time? Of if you would like to discuss any problems, please type your name and a phone number below and someone will contact you back.

Thank You For Submitting!

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