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GIVN Regional Emergency Medical Services Survey

1.Do you know which agency or organization provides ambulance services in your community?
2.Have you or someone in your household ever needed an ambulance?
3.Based on your knowledge or personal experience, how would you rate the ambulance service available in your community?
4.If you needed an ambulance today, how confident are you that one would arrive within 30 minutes?
5.In your opinion, what factors contribute most to delays in ambulance response? (Check all that apply.)
6.How much do distance and geography affect emergency response times where you live?
7.How concerned are you about the availability of emergency medical services in your community over the next five years?
8.If an ambulance took longer than expected to arrive, would you know what to do while waiting?
9.Have you ever delayed calling 911 because of concerns about ambulance costs?
10.How would you rate the coordination between local emergency responders, hospitals, and ambulance services?
11.Overall, how would you rate emergency medical services in your community?
12.What improvements would you most like to see? (Choose up to three.)
13.Have you ever personally experienced what you felt was a delayed ambulance response?
14.How important is it for rural communities to invest additional resources into emergency medical services?
15.Demographic Question - Age
16.Demographic Question - County of Residence:
17.Demographic Question - Do you live:
18.One Final Question - If you could change one thing about emergency medical care in your community, what would it be?