Patient 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).

Were you the patient?*
- Yes
- No
- Parent or Guardian
- Authorized Representative
- Other
What is your age group?*
- <18
- 18 - 30
- 31 - 50
- 50 - 65
- 65 - 80
- >80
What was the location of the emergency?*
- Reedley
- Orange Cove
- Parlier
- Other
What type of emergency?*
- Medical / Illness
- Trauma / Injury
- N/A
How would you rate the response time of the ambulance?*
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
Ambulance Crew Ability*
How would you rate the ambulance crew's abilities to explain what they were doing and why?
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
Crew Professionalism*
How would you rate the professionalism of the ambulance crews?
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
Timeliness and Quality*
How would you rate the timeliness and quality of our EMS provider's response to your needs?
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
Overall Performance*
Overall, how would you rate our performance?
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
How Likely to Use Again?
Based on our performance, how confident are you in requesting our services again in the future?
- Excellent
- Good
- Adequate
- Poor
- Unacceptable
- N/A
How else may we improve?
Any suggestions on how we can improve our service?
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Name
This field is for validation purposes and should be left unchanged.

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