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1. Date of Transport (Required.)

Date

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2. Name

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3. How would you rate the professionalism / appearance of the crew?

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4. How would you rate the cleanliness of the ambulance and/or equipment?

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5. Were you treated with courtesy and respect?

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6. How well did the provider explain your care and answer your questions?

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7. How would you rate your overall experience with the Staunton Augusta Rescue Squad?

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