Boston EMS Patient Satisfaction Survey Question Title * 1. Incident Number: Question Title * 2. C# Question Title * 3. Account number Question Title * 4. Phone number: Question Title * 5. Call to 911: Excellent Good Fair Poor N/A Courtesy of the 911 call operator Courtesy of the 911 call operator Excellent Courtesy of the 911 call operator Good Courtesy of the 911 call operator Fair Courtesy of the 911 call operator Poor Courtesy of the 911 call operator N/A Usefulness and clarity of instruction provided by the 911 call operator Usefulness and clarity of instruction provided by the 911 call operator Excellent Usefulness and clarity of instruction provided by the 911 call operator Good Usefulness and clarity of instruction provided by the 911 call operator Fair Usefulness and clarity of instruction provided by the 911 call operator Poor Usefulness and clarity of instruction provided by the 911 call operator N/A Question Title * 6. Boston EMS Personnel: Excellent Good Fair Poor N/A Professionalism/appearance Professionalism/appearance Excellent Professionalism/appearance Good Professionalism/appearance Fair Professionalism/appearance Poor Professionalism/appearance N/A Knowledgeable about your complaint Knowledgeable about your complaint Excellent Knowledgeable about your complaint Good Knowledgeable about your complaint Fair Knowledgeable about your complaint Poor Knowledgeable about your complaint N/A Quality of care provided Quality of care provided Excellent Quality of care provided Good Quality of care provided Fair Quality of care provided Poor Quality of care provided N/A Concern shown for your needs Concern shown for your needs Excellent Concern shown for your needs Good Concern shown for your needs Fair Concern shown for your needs Poor Concern shown for your needs N/A Concern shown for the needs of your family/friends Concern shown for the needs of your family/friends Excellent Concern shown for the needs of your family/friends Good Concern shown for the needs of your family/friends Fair Concern shown for the needs of your family/friends Poor Concern shown for the needs of your family/friends N/A Explanation of procedures performed Explanation of procedures performed Excellent Explanation of procedures performed Good Explanation of procedures performed Fair Explanation of procedures performed Poor Explanation of procedures performed N/A Question Title * 7. Cleanliness: Excellent Good Fair Poor N/A Cleanliness of the ambulance and equipment Cleanliness of the ambulance and equipment Excellent Cleanliness of the ambulance and equipment Good Cleanliness of the ambulance and equipment Fair Cleanliness of the ambulance and equipment Poor Cleanliness of the ambulance and equipment N/A Question Title * 8. Overall Satisfaction: Excellent Good Fair Poor N/A Overall satisfaction with the service you received Overall satisfaction with the service you received Excellent Overall satisfaction with the service you received Good Overall satisfaction with the service you received Fair Overall satisfaction with the service you received Poor Overall satisfaction with the service you received N/A Question Title * 9. Please provide any additional comments below or call 617-343-1200 for customer service assistance. Done
