EXIT Fishers Fire Department EMS Patient Satisfaction Survey General Information We want to thank you in advance for completing our survey. Your response will help us in improving our service to the citizens that we serve OK Question Title * Date of Service On what Date did you require Fishers EMS response Date OK Question Title * Is Patient Male Female Non-Binary Prefer not to Answer OK Question Title * What is patient's age? Under 18 18 to 30 31 to 44 45 to 54 55 to 64 65 to 70 71-80 81+ Prefer to not answer OK INSTRUCTIONS: Please rate the services you received while using our ambulance service. Click on the dot that best describes your experience. If a question does not apply to you or is unknown, please mark N/A. Space is provided for you to comment on positive or negative experiences that may have happened to you. OK Question Title * The person you called for service (911 Call Taker) Poor Fair Good Very Good N/A Helpfulness of the 911 Call Taker when you called for EMS Helpfulness of the 911 Call Taker when you called for EMS Poor Helpfulness of the 911 Call Taker when you called for EMS Fair Helpfulness of the 911 Call Taker when you called for EMS Good Helpfulness of the 911 Call Taker when you called for EMS Very Good Helpfulness of the 911 Call Taker when you called for EMS N/A Concern shown by the Call Taker Concern shown by the Call Taker Poor Concern shown by the Call Taker Fair Concern shown by the Call Taker Good Concern shown by the Call Taker Very Good Concern shown by the Call Taker N/A Extent to which you were told what to do until the ambulance arrived Extent to which you were told what to do until the ambulance arrived Poor Extent to which you were told what to do until the ambulance arrived Fair Extent to which you were told what to do until the ambulance arrived Good Extent to which you were told what to do until the ambulance arrived Very Good Extent to which you were told what to do until the ambulance arrived N/A Comments (describe positive or negative experiences): OK NEXT