Hamilton Paramedic Service Patient/Customer Survey Question Title * 1. Were you the patient? Yes No Other (please specify) Question Title * 2. If you were not the patient, what is your relationship to the patient? Spouse/Partner Relative Caregiver (not relative) Other (please specify) Question Title * 3. Were you at the scene of the incident involving the patient? Yes No Question Title * 4. What was the reason for the ambulance call? Please give reason Other (please specify) Question Title * 5. Did the Paramedics take care of your problem? Yes No Other (please specify) Question Title * 6. Did the Paramedics explain what they were doing? Yes No Other (please specify) Question Title * 7. Overall, rate the ride in the Ambulance Excellent Great Good Mostly bad Bad Excellent Great Good Mostly bad Bad Question Title * 8. Did the Paramedics make you comfortable? Yes No Other (please specify) Question Title * 9. Overall, how professional were the Paramedics? Extremely Very Somewhat Not very Not at all Extremely Very Somewhat Not very Not at all Question Title * 10. Overall, how would you rate the performance of the Paramedics? Excellent Above Average Average Below Average Poor Excellent Above Average Average Below Average Poor Question Title * 11. The Service that the Hamilton Paramedic Service provides is important to me. Strongly Agree Agree Disagree Strongly Disagree Don't have an opinion Strongly Agree Agree Disagree Strongly Disagree Don't have an opinion Question Title * 12. Please enter your Name and Contact Information. Done