EMS Telehealth Survey

Thank you for taking 5 minutes to indicate your level of involvement interest in the South Dakota EMS telehealth initiative. After the survey results are collected, our team will reach out to provide detailed next steps. We are thrilled to partner with each of you in this groundbreaking opportunity! For questions or concerns, please contact me at Marty.Link@state.sd.us.

Question Title

* 1. Please indicate your level of interest in this telehealth initiative

We are supportive, and request to be an early adopter in phase one of implementation

We are supportive, and request to be part of phase two of implementation

We are supportive, but would like additional information before deciding

We are opting out of this opportunity. Please provide reason for opting out.

Question Title

* 2. Please complete the following

Name of your agency

Location of your agency (City)

Name of primary contact

Email of primary contact

Phone of primary contact