Sequoia Safety Council - Patient Satisfaction Survey

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PATIENT SURVEY LINKS

Patient Satisfaction Survey
We're committed to monitoring the quality of the services provided by Sequoia Safety Council, Inc. As part of an ongoing improvement process, we would appreciate your feedback on our performance. (All submissions are anonymous).
1. WERE YOU THE PATIENT?	Yes No Parent or Guardian Authorized Representative Other

2. WHAT IS YOUR AGE GROUP?	<18 18 - 30 31 - 50 50 - 65 65 - 80 >80

3. WHAT WAS THE LOCATION OF THE EMERGENCY?	Reedley Orange Cove Parlier Other

4. WHAT TYPE OF EMERGENCY?	Medical / Illness Trauma / Injury N/A

5. HOW WOULD YOU RATE THE RESPONSE TIME OF THE AMBULANCE?	Excellent Good Adequate Poor Unacceptable N/A

6. HOW WOULD YOU RATE THE AMBULANCE CREW'S ABILITIES TO EXPLAIN WHAT THEY WERE DOING AND WHY?	Excellent Good Adequate Poor Unacceptable N/A

7. HOW WOULD YOU RATE THE PROFESSIONALISM OF THE AMBULANCE CREWS?	Excellent Good Adequate Poor Unacceptable N/A

8. HOW WOULD YOU RATE THE TIMELINESS AND QUALITY OF OUR EMS PROVIDERS RESPONSE TO YOUR NEEDS?	Excellent Good Adequate Poor Unacceptable N/A

9. OVERALL, HOW WOULD YOU RATE OUR PERFORMANCE?	Excellent Good Adequate Poor Unacceptable N/A

10. BASED ON OUR PERFORMANCE, HOW CONFIDENT ARE YOU IN REQUESTING OUR SERVICES AGAIN IN THE FUTURE?	Very Confident Confident Somewhat Not At All

11. IF YOU WERE NOT SATISFIED WITH SERVICE PROVIDED PLEASE TELL US WHY. IF YOU WOULD LIKE SOMEONE FROM SEQUOIA SAFETY COUNCIL TO CALL YOU TO DISCUSS YOUR EXPERIENCE, PLEASE LEAVE YOUR CONTACT INFORMATION.

12. ANY SUGGESTIONS ON HOW WE CAN IMPROVE OUR SERVICE?

13. PLEASE PROVIDE SUGGESTIONS OR ADDITIONAL INFORMATION SO THAT WE CAN IMPROVE SERVICE PROVIDED.