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Customer Satisfaction Questionnaire

Please help us improve our services by responding to the questions below.
We are interested in your opinion about the recent service you received from OCA.

Use of Information: The information provided in this survey may be used by Orange Cross Ambulance, Inc. for business purposes, including but not limited to, improving our services, addressing customer concerns, and marketing activities. By submitting your feedback, you agree that we may use any comments or testimonials in our promotional materials. Your name will be kept confidential unless explicit permission is obtained from you.
1.Please enter your full name or call number.(Required.)
2.May we cite your comments by name in our materials, or would you prefer to remain confidential? Please indicate your choice.(Required.)
3.Were you the patient?
4.Were our personnel polite and courteous?
5 - Very Satisfied
4 - Satisfied
3 - Adequate
2 - Unsatisfied
1 - Very Unsatisfied
5.Did our personnel take care of you in a professional manner?
5 - Very Satisfied
4 - Satisfied
3 - Adequate
2 - Unsatisfied
1 - Very Unsatisfied
6.Did we explain the services you needed in an understandable manner?
5 - Very Satisfied
4 - Satisfied
3 - Adequate
2 - Unsatisfied
1 - Very Unsatisfied
7.Did we answer all of your questions in an understandable way?
5 - Very Satisfied
4 - Satisfied
3 - Adequate
2 - Unsatisfied
1 - Very Unsatisfied
8.How likely are you to recommend Orange Cross Ambulance to a friend or relative?
9.Overall how satisfied were you with the service you received from us?
5 - Very Satisfied
4 - Satisfied
3 - Adequate
2 - Unsatisfied
1 - Very Unsatisfied
10.Did you have any other concerns, related to your emergency, that you felt were not addressed by our personnel?
11.Please tell us the single most important action we took that made you feel better.
12.What could we have done differently that might have made your experience more positive?
13.Do you have any positive feedback we should pass along to the EMTs/Paramedics that took care of you?
14.Would you like a follow up call?