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HOW DID WE DO?
HOW DID WE DO?
AmeriPro Health is dedicated to Customer Service and Quality Patient Care that exceeds our customers' expectations.
Please assist us by completing this brief three-minute survey.
1.
What type of transport was this?
911 Emergency Response
Scheduled Interfacility Transport (IFT)
Urgent / Unscheduled Interfacility Transport (IFT)
I'm not sure
2.
Response Time: On a scale of 1 to 5, with 1 being dissatisfied and 5 being very satisfied, how satisfied were you with the time it took for the ambulance to arrive at your location after the call was placed?
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5
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5
3.
Professionalism and Courtesy: On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how would you rate the professionalism, courtesy, and compassion shown by the paramedics/EMTs during your interaction?
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5
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5
4.
Patient Experience of Care: On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how well did the crew keep you (or the patient) informed, comfortable, and at ease during the transport?
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5
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5.
Patient Dignity and Comfort: On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how would you rate the way the crew treated the patient with dignity, respect, and attention to physical comfort during the transport?
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6.
Communication: On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how satisfied were you with the clarity of our dispatch center in the following areas:
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5
Taking your initial call
Providing instructions during the call
Scheduling/coordinating your transport?
7.
Transport Timeliness (Interfacility Transports): On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how satisfied were you with the on-time performance of the pickup and/or delivery for this transport? (Skip if this was a 911 emergency response)
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5
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5
8.
Facility Communication (Interfacility Transports): On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, how well did the crew communicate with the receiving facility staff during the transport? (Skip if this was a 911 emergency response)
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5
9.
Overall Satisfaction: On a scale of 1 to 5 with 1 being dissatisfied and 5 being very satisfied, taking all factors into consideration — response time, crew behavior, communication, and quality of care — how satisfied were you with the overall service provided by AmeriPro Health?
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10.
Crew / Unit Number: If known, please enter the crew names or unit/truck number for this transport. (This helps us recognize great performance and address any concerns.)
11.
On a scale of 0 to 10,
How likely is it that you would recommend this service to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
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12.
Facility/Company Name
13.
Your Name (Optional)
14.
If today's response is related to a specific patient transport, please enter the date of transport.
Date / Time
Date
January
February
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December
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15.
What is one thing AmeriPro Health could have done better during this transport?
16.
Please provide any further feedback you may have in regards to the service you receive from AmeriPro Health.