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FEEDBACK

YOUR OPINION IS VERY IMPORTANT

Please assist us in meeting your needs by completing this simple customer survey. Providing high quality Service, Protection and Education to our community with Pride and Professionalism is our Mission and prime concern. The best way for us to continually improve our services is by receiving prompt feedback from our customers.

We appreciate you giving your valuable time and opinions about our services!

Optional Contact Information
First Name:
Last Name:
Address:
Address 2:
City:
State:
Zip:
Phone:
Email Address:
   
Feedback
What was the Date and approximate time of your emergency?   
Call Number:  
How would you rate your overall level of satisfaction with us?   
 
How would you rate us on the following attributes?
  Excellent Well Above Average Above Average Average Below Average Well Below Average Extremely Poor
Customer Service
Professionalism
Response Time
Appearance and Cleanliness of Vehicles
Level of Care Received
Comfort provided by EMS Personnel
Courtesy and Respect
Explanation of Treatment
Regard for Family and Friends
EMS Dispatch and Assistance
Appearance of EMS Personnel
 
How likely are you to share your experience with us with family, friends or coworkers?  
What is your gender?  
Which category describes your age?  
What best describes your employment status?  
Do you have any suggestions for improving our services?
   
 

 

 

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