Patient Satisfaction
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At Oldham County EMS, we want to ensure that every patient we treat and their family receive prompt, courteous and professional care. So that we can effectively measure how were doing, we have constructed this survey. If you wouldn't mind, please complete this short survey so that we can make our service as effective as possible.

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1. Please indicate the date and time of our response to your emergency call / transport.

	MM		DD		YYYY		HH		MM	AM/PM
Date:	Please indicate the date and time of our response to your emergency call / transport. Date: Month	/	Day	/	Year		Hour	:	Minute	AM or PM

2. How many times in the past 12 months have you utilized services from OCEMS?

How many times in the past 12 months have you utilized services from OCEMS?

3. How would you rate communications between the OCEMS responders and the patient and/or their family?

	Poor	Below Average	Average	Above Average	Outstanding	N/A
1.	*How would you rate communications between the OCEMS responders and the patient and/or their family? 1. Poor	1. Below Average	1. Average	1. Above Average	1. Outstanding	1. N/A

Other (please specify)

4. How would you rate the professionalism / appearance of Oldham County EMS personnel?

	Poor	Below Average	Average	Above Average	Outstanding	N/A
1.	*How would you rate the professionalism / appearance of Oldham County EMS personnel? 1. Poor	1. Below Average	1. Average	1. Above Average	1. Outstanding	1. N/A

5. How would you rate the cleanliness of the ambulance and equipment?

	Poor	Below Average	Average	Above Average	Outstanding	N/A
1.	*How would you rate the cleanliness of the ambulance and equipment? 1. Poor	1. Below Average	1. Average	1. Above Average	1. Outstanding	1. N/A

6. Did the OCEMS responding crew explain treatment options?

Did the OCEMS responding crew explain treatment options? Yes - The crew explained what was being done.

No - The crew did not communicate with me.

N/A - Due to my medical condition, I was unable to communicate with the crew.

7. If you were transported to the hospital, were you given the choice of which hospital to visit?

If you were transported to the hospital, were you given the choice of which hospital to visit? Yes

Unable to choose due to medical condtion.

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Patient SatisfactionExit this survey

*1. Please indicate the date and time of our response to your emergency call / transport.