If you wish to provide the names of the EMT / Parmedic that provided care, please fill out the boxes.

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* 1. If you wish to provide the names of the EMT / Parmedic that provided care, please fill out the boxes.

Date you used Chaffee County EMS

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* 2. Date you used Chaffee County EMS

How professional is our company?

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* 3. How professional is our company?

How would you rate the ambulance crews communication skills ?

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* 4. How would you rate the ambulance crews communication skills ?

I am satisfied wth the amount of time it took for the ambulance to arrive.

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* 5. I am satisfied wth the amount of time it took for the ambulance to arrive.

If I had Pain it was well managed.

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* 6. If I had Pain it was well managed.

Paying my bill was easy

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* 7. Paying my bill was easy

Comments:

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* 8. Comments:

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