Tell us how we did!

Daisy Mountain Fire & Medical (DMFM) strives to provide honorable, compassionate, and exceptional customer service at every opportunity.  At the core of this mission is our commitment to the highest quality prehospital medical care.  To ensure we are meeting the needs of the communities we serve; we are asking our patients and customers to offer their feedback.  We ask that you tell us what we are doing right, and where improvements can be made. 

*Please Note: DO NOT PROVIDE ANY MEDICAL INFORMATION IN THIS SURVEY. 

Only offer information you are comfortable sharing.  Your answers will only be seen by DMFM administrative staff.   There is a section at the end to leave comments if you choose. 

We appreciate your time and thank you for completing our survey.

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* 1. Who is completing this survey?

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* 2. Do you recall the date of the incident?

Date

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* 3. Would you like to share your name?

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* 4. Overall, how satisfied are you with the service provided by DMFM crews?

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* 5. Professionalism of DMFM Crews?

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* 6. The level of concern DMFM crews showed for your needs?

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* 7. Degree to which DMFM crews included you in the treatment that was provided?

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* 8. Degree to which DMFD crews explained the plan of care and procedures performed?

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* 9. What was the outcome of your interaction with us?

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* 10. Please offer any additional comments or suggestions below:
Note: Do not provide medical information

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* 11. Is there someone from our staff that was especially helpful? We would like to make sure they hear your feedback.  

Thank you for completing our survey.  Your feedback is important to us.  For questions about your ambulance bill or your medical records, please contact our billing office at 623-465-7400, option 1. 

For more information about Daisy Mountain Fire & Medical, please visit our website at www.daisymountainfire.org.

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