Coastal Medical Transportation Services
Customer & Patient Satisfaction Survey
Transport Details

Question Title

* Transport Details

Date of Transport
Your Information (Optional)

Question Title

* Your Information (Optional)

Service and Experience Ratings

Question Title

* Service and Experience Ratings

  Strongly Agree Agree Neutral Disagree Strongly Disagree Not applicable
I would recommend Coastal Ambulance to a family member of friend.
The employees I interacted with were neat and professional in their appearance.
The vehicle was clean and neat.
The employees I interacted with were respectful, courteous, and professional.
The ambulance or transit vehicle ride was comfortable.
I felt safe at all times during my care and transport.
Ambulance crew members took the time to explain my care and treatment.
Billing, office, or administrative staff were helpful.
Is there anything we could have done better?

Question Title

* Is there anything we could have done better?

Do you have any other comments or suggestions?

Question Title

* Do you have any other comments or suggestions?

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