Snohomish County EMS Patient Feedback Survey

Thank you for taking time to complete the Snohomish County EMS Patient Feedback Survey. We value your input and are interested in learning more about your recent experience with Snohomish County EMS agencies. This survey should take approximately five minutes to complete. If you would like to include comments and/or your contact information, space is provided at the end of the survey.

	Excellent	Good	Fair	Poor	Not applicable
Professionalism of the 9-1-1 call operator	Professionalism of the 9-1-1 call operator Excellent	Professionalism of the 9-1-1 call operator Good	Professionalism of the 9-1-1 call operator Fair	Professionalism of the 9-1-1 call operator Poor	Professionalism of the 9-1-1 call operator Not applicable
Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel	Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Excellent	Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Good	Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Fair	Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Poor	Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Not applicable
Professionalism of Snohomish County EMS personnel	Professionalism of Snohomish County EMS personnel Excellent	Professionalism of Snohomish County EMS personnel Good	Professionalism of Snohomish County EMS personnel Fair	Professionalism of Snohomish County EMS personnel Poor	Professionalism of Snohomish County EMS personnel Not applicable
SCEMS personnel knowledge/understanding of your complaint	SCEMS personnel knowledge/understanding of your complaint Excellent	SCEMS personnel knowledge/understanding of your complaint Good	SCEMS personnel knowledge/understanding of your complaint Fair	SCEMS personnel knowledge/understanding of your complaint Poor	SCEMS personnel knowledge/understanding of your complaint Not applicable
Quality of care provided by SCEMS personnel	Quality of care provided by SCEMS personnel Excellent	Quality of care provided by SCEMS personnel Good	Quality of care provided by SCEMS personnel Fair	Quality of care provided by SCEMS personnel Poor	Quality of care provided by SCEMS personnel Not applicable
Concern SCEMS personnel showed for your questions or worries	Concern SCEMS personnel showed for your questions or worries Excellent	Concern SCEMS personnel showed for your questions or worries Good	Concern SCEMS personnel showed for your questions or worries Fair	Concern SCEMS personnel showed for your questions or worries Poor	Concern SCEMS personnel showed for your questions or worries Not applicable
Concern SCEMS personnel showed for the needs of your family and friends	Concern SCEMS personnel showed for the needs of your family and friends Excellent	Concern SCEMS personnel showed for the needs of your family and friends Good	Concern SCEMS personnel showed for the needs of your family and friends Fair	Concern SCEMS personnel showed for the needs of your family and friends Poor	Concern SCEMS personnel showed for the needs of your family and friends Not applicable
Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand	Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Excellent	Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Good	Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Fair	Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Poor	Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Not applicable
Overall satisfaction with the service you received from Snohomish County EMS personnel	Overall satisfaction with the service you received from Snohomish County EMS personnel Excellent	Overall satisfaction with the service you received from Snohomish County EMS personnel Good	Overall satisfaction with the service you received from Snohomish County EMS personnel Fair	Overall satisfaction with the service you received from Snohomish County EMS personnel Poor	Overall satisfaction with the service you received from Snohomish County EMS personnel Not applicable

Excellent

Good

Fair

Poor

Not applicable

Professionalism of the 9-1-1 call operator

Professionalism of the 9-1-1 call operator Excellent

Professionalism of the 9-1-1 call operator Good

Professionalism of the 9-1-1 call operator Fair

Professionalism of the 9-1-1 call operator Poor

Professionalism of the 9-1-1 call operator Not applicable

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Excellent

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Good

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Fair

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Poor

Usefulness of instruction provided by the 9-1-1 call operator prior to the arrival of EMS personnel Not applicable

Professionalism of Snohomish County EMS personnel

Professionalism of Snohomish County EMS personnel Excellent

Professionalism of Snohomish County EMS personnel Good

Professionalism of Snohomish County EMS personnel Fair

Professionalism of Snohomish County EMS personnel Poor

Professionalism of Snohomish County EMS personnel Not applicable

SCEMS personnel knowledge/understanding of your complaint

SCEMS personnel knowledge/understanding of your complaint Excellent

SCEMS personnel knowledge/understanding of your complaint Good

SCEMS personnel knowledge/understanding of your complaint Fair

SCEMS personnel knowledge/understanding of your complaint Poor

SCEMS personnel knowledge/understanding of your complaint Not applicable

Quality of care provided by SCEMS personnel

Quality of care provided by SCEMS personnel Excellent

Quality of care provided by SCEMS personnel Good

Quality of care provided by SCEMS personnel Fair

Quality of care provided by SCEMS personnel Poor

Quality of care provided by SCEMS personnel Not applicable

Concern SCEMS personnel showed for your questions or worries

Concern SCEMS personnel showed for your questions or worries Excellent

Concern SCEMS personnel showed for your questions or worries Good

Concern SCEMS personnel showed for your questions or worries Fair

Concern SCEMS personnel showed for your questions or worries Poor

Concern SCEMS personnel showed for your questions or worries Not applicable

Concern SCEMS personnel showed for the needs of your family and friends

Concern SCEMS personnel showed for the needs of your family and friends Excellent

Concern SCEMS personnel showed for the needs of your family and friends Good

Concern SCEMS personnel showed for the needs of your family and friends Fair

Concern SCEMS personnel showed for the needs of your family and friends Poor

Concern SCEMS personnel showed for the needs of your family and friends Not applicable

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Excellent

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Good

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Fair

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Poor

Degree to which SCEMS personnel explained the procedures they performed in a manner that you could understand Not applicable

Overall satisfaction with the service you received from Snohomish County EMS personnel

Overall satisfaction with the service you received from Snohomish County EMS personnel Excellent

Overall satisfaction with the service you received from Snohomish County EMS personnel Good

Overall satisfaction with the service you received from Snohomish County EMS personnel Fair

Overall satisfaction with the service you received from Snohomish County EMS personnel Poor

Overall satisfaction with the service you received from Snohomish County EMS personnel Not applicable

Snohomish County EMS Patient Feedback Survey

We want to know what you think!

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Date and approximate time of call/incident:

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Do you know which department responded?

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Street address or location of incident:

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Which best describes the nature of your emergency?

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Number of times you (or someone else on your behalf) called 9-1-1 in the last 12 months?

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Please offer any additional comments or suggestions in the space below:

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If any SCEMS providers were especially helpful, please let us know who they are. We would like to show them our appreciation.

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Contact information (optional):

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Do you wish to be contacted by Snohomish County EMS regarding this survey?