Satisfaction Survey

Dear Patient, Family or Facility,

The staff at Care Plus is committed to providing excellent ambulance services to all of our patients. Please take a moment of your time to answer these questions. Your feedback will assist us in continuously improving the quality of care and services we provide. We do not disclose any personal information to third parties.

Sincerely,
Care Plus
1. The dispatcher or service representative on the phone was courteous and helpful.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


2. Care Plus Ambulance arrived at the appointed time.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


3. Care Plus personnel acted in a compassionate and caring manner.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


4. Care Plus personnel were knowledgeable and competent.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


5. Care Plus personnel were polite and respectful.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


6. Care Plus personnel were professional.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


7. Care Plus personnel communicated clearly with me or my family members.
  • Strongly Agree
  • Agree
  • Neutral
  • Disagree
  • Strongly Disagree


8. The overall quality of care I received from Care Plus was:
  • Excellent
  • Good
  • Fair
  • Poor
  • Very Poor


9. The overall actions of the Care Plus personnel caused my situation to:
  • Improve
  • Remain the Same
  • Worsen


10. Additional Comments:


Optional:
First Name:
Last Name:
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