Exit this survey EMS Patient Care Survey Question Title * 1. Were you the patient? Yes No Parent or Guardian Authorized Representative Other Question Title * 2. What is your age group? <18 18-30 31-50 51-64 65-80 >80 Question Title * 3. What type of emergency? Medical/Illness Trauma/Injury N/A Question Title * 4. How would you rate the EMS providers abilities to explain what they were doing and why? Excellent Good Adequate Poor Unacceptable N/A Question Title * 5. How would you rate the professionalism of the fire services personnel? Excellent Good Adequate Poor Unacceptable N/A Question Title * 6. How would you rate the quality of our EMS providers response to your needs? Excellent Good Adequate Poor Unacceptable N/A Question Title * 7. Overall, how would you rate our performance? Excellent Good Adequate Poor Unacceptable N/A Question Title * 8. Based on our performance, how confident are you in requesting our services again in the future? Very Confident Confident Somewhat Confident Not Confident Not At All Confident Question Title * 9. If you were not satisfied with our service please tell us why. If you would like the EMS Chief to contact you regarding your experience, please leave your contact information. Question Title * 10. Do you have any suggestions on how we can improve our service? Done