* 1. Date(s) American Ambulance Service was used:

First Date of Service:
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Second Date of Service:
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Third Date of Service:
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* 2. From which city, town, or medical facility did American Ambulance pick you up?

* 3. Trip Number(s) found on your bill(s), if available:

If you would like to speak with a Supervisor, please call
In Maine: (207) 703-1152
In Massachusetts: (617) 361-4800
In New Hampshire: (603) 480-5600


PLEASE RATE THE FOLLOWING ASPECTS OF OUR SERVICE:

* 4. TIME it took the ambulance to arrive:

* 5. Ambulance crew's PROFESSIONALISM:

* 6. Ambulance crew's COMPASSION:

* 7. Ambulance crew's KNOWLEDGE:

* 8. The MEDICAL CARE you received:

* 9. How well the ambulance crew WORKED TOGETHER:

* 10. Ambulance crew's APPEARANCE:

* 11. Ambulance's APPEARANCE/CLEANLINESS:

* 12. COMFORT of the AMBULANCE RIDE:

* 13. HELPFULNESS of the Billing Staff (If Utilized):

* 14. COURTESY of the Billing Staff (If Utilized):

* 15. Would you RECOMMEND American Ambulance?

* 16. Additional Comments:

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