Air Link Customer Satisfaction Survey

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* 8. Why did you choose Air Link? Please check all that apply.

Response time

Patient bedside time prior to departure

Professionalism

Confidence in flight crew's skills

Courteous/respectful

Patient follow up

Other (please specify)

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* 9. If you have had the opportunity to use another flight service, what factors led you to make that decision? Please check all that apply.

Air Link unavailable

Response time

Patient bedside time prior to departure

Professionalism

Confidence in flight crew's skills

Courteous/respectful

Patient follow up

Have not used another flight service

Receiving facility dictated transport service used

Other (please specify)

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* 10. During the transfer process did the Transfer Center Specialist competently handle your request?

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* 11. If no, what could have been handled differently?

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* 12. Please evaluate the following statements in regard to your satisfaction level.

	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied	Extremely Satisfied	N/A
Accuracy of the estimated time of arrival	Accuracy of the estimated time of arrival Not Satisfied	Accuracy of the estimated time of arrival Somewhat Satisfied	Accuracy of the estimated time of arrival Satisfied	Accuracy of the estimated time of arrival Very Satisfied	Accuracy of the estimated time of arrival Extremely Satisfied	Accuracy of the estimated time of arrival N/A
Changes in arrival time were communicated to your facility	Changes in arrival time were communicated to your facility Not Satisfied	Changes in arrival time were communicated to your facility Somewhat Satisfied	Changes in arrival time were communicated to your facility Satisfied	Changes in arrival time were communicated to your facility Very Satisfied	Changes in arrival time were communicated to your facility Extremely Satisfied	Changes in arrival time were communicated to your facility N/A
Was concern shown to the patient and family by the flight personnel?	Was concern shown to the patient and family by the flight personnel? Not Satisfied	Was concern shown to the patient and family by the flight personnel? Somewhat Satisfied	Was concern shown to the patient and family by the flight personnel? Satisfied	Was concern shown to the patient and family by the flight personnel? Very Satisfied	Was concern shown to the patient and family by the flight personnel? Extremely Satisfied	Was concern shown to the patient and family by the flight personnel? N/A
Competence demonstrated by the flight personnel	Competence demonstrated by the flight personnel Not Satisfied	Competence demonstrated by the flight personnel Somewhat Satisfied	Competence demonstrated by the flight personnel Satisfied	Competence demonstrated by the flight personnel Very Satisfied	Competence demonstrated by the flight personnel Extremely Satisfied	Competence demonstrated by the flight personnel N/A
Respect shown to you and your staff	Respect shown to you and your staff Not Satisfied	Respect shown to you and your staff Somewhat Satisfied	Respect shown to you and your staff Satisfied	Respect shown to you and your staff Very Satisfied	Respect shown to you and your staff Extremely Satisfied	Respect shown to you and your staff N/A
Attention given to your report about the patient	Attention given to your report about the patient Not Satisfied	Attention given to your report about the patient Somewhat Satisfied	Attention given to your report about the patient Satisfied	Attention given to your report about the patient Very Satisfied	Attention given to your report about the patient Extremely Satisfied	Attention given to your report about the patient N/A
Flight transport personnel worked together to care for the patient	Flight transport personnel worked together to care for the patient Not Satisfied	Flight transport personnel worked together to care for the patient Somewhat Satisfied	Flight transport personnel worked together to care for the patient Satisfied	Flight transport personnel worked together to care for the patient Very Satisfied	Flight transport personnel worked together to care for the patient Extremely Satisfied	Flight transport personnel worked together to care for the patient N/A
Ease of working with the Air Link transport service	Ease of working with the Air Link transport service Not Satisfied	Ease of working with the Air Link transport service Somewhat Satisfied	Ease of working with the Air Link transport service Satisfied	Ease of working with the Air Link transport service Very Satisfied	Ease of working with the Air Link transport service Extremely Satisfied	Ease of working with the Air Link transport service N/A
Overall rating of Air Link transport service	Overall rating of Air Link transport service Not Satisfied	Overall rating of Air Link transport service Somewhat Satisfied	Overall rating of Air Link transport service Satisfied	Overall rating of Air Link transport service Very Satisfied	Overall rating of Air Link transport service Extremely Satisfied	Overall rating of Air Link transport service N/A

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* 13. Have you been trained in helicopter and landing zone safety?

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* 14. If you answered no to the previous question, would you like Air Link to provide training?

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* 15. What other educational topics would you like to see Air Link offer?

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* 16. Would you like to be added to our email list to receive education opportunity updates, newsletters, and/or other Air Link materials? If yes, please ensure your email address is entered above.

Air Link Customer Satisfaction Survey

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* 1. Name

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* 2. Email address

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* 3. Name of sending facility

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* 4. Name of receiving facility

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* 5. Date/Time of flight

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* 6. Please list your title (RN, MD, EMT, etc)

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* 7. Was Air Link your first choice of transport for this patient?

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* 8. Why did you choose Air Link? Please check all that apply.

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* 9. If you have had the opportunity to use another flight service, what factors led you to make that decision? Please check all that apply.

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* 10. During the transfer process did the Transfer Center Specialist competently handle your request?

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* 11. If no, what could have been handled differently?

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* 12. Please evaluate the following statements in regard to your satisfaction level.

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* 13. Have you been trained in helicopter and landing zone safety?

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* 14. If you answered no to the previous question, would you like Air Link to provide training?

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* 15. What other educational topics would you like to see Air Link offer?

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* 16. Would you like to be added to our email list to receive education opportunity updates, newsletters, and/or other Air Link materials? If yes, please ensure your email address is entered above.

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* 17. Other comments: