Patient Care Satisfaction

Please take about 2 minutes to complete this survey! Your responses are not track but are used to identify how we providing care and where it can be improved! Please fill out every field and submit the survey. Thank you very much!

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* 1. What is your Run Number?

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* 2. How likely is it that you would recommend Warren-Wentworth Ambulance Service to a friend or colleague?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 3. Please rate the EMS personnel on the following topics

  Not Satisfactory Somewhat Satisfactory Mildly Satisfactory Satisfactory Very Satisfactory
Competency
Professionalism
Compasion for you and your family
Efficiency
Atentive Listener
Perceived Knowledge
Communicated Effectively

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* 4. Cleanliness of Ambulance/equipment

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* 5. Did you receive a copy of our privacy notice?

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* 6. How would you rate our response time?

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* 7. Overall satisfaction with Warren-Wentworth Ambulance Service

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* 8. Do you have any other comments, questions, or concerns?

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* 9. If any members of our staff were especially helpful, please let us know who they are. We would like to show them our appreciation.

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* 10. Would you like to be contacted by Warren-Wentworth Ambulance Service regarding this survey?

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