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* 1. Who is your current EMS employer?

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* 2. Of the options provided, what local HCA Emergency Department do you transport to most often?

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* 3. Thinking about the HCA Emergency Department you selected above, answer the following statements.

  Strongly Agree Agree Neutral (neither agree nor disagree) Disagree Strongly Disagree
Patients receive quality care in this emergency room.
Emergency room nursing staff are courteous and responsive to me.
Emergency room physicians are courteous and responsive to me.
I would take my family to this emergency room for care.
A room or bed is immediately made available to receive my patient.
The Emergency Department Nurses and Physicians listen to my report and value my input.
The EMS workroom is easily accessible and generally clean and tidy.
The EMS workroom is stocked with snacks and drinks.
The hospital provides useful clinical outcomes information to EMS personnel.
Radio communication with this hospital ED is consistently positive and effective.

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* 4. Thinking about the Emergency Department you selected in question #2, what service lines do you feel could be enhanced?

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* 5. We are committed to supporting your education needs. Please rank your preference of the following training formats with 1 being the most preferred.

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* 6. Considering your educational needs, please rank the following topics from highest to lowest priority with 1 being the highest.

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* 7. Additional areas of education not mentioned above:

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* 8. Do you have any other comments, questions, or concerns?

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