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Brevard County Fire Rescue Customer Satisfaction Survey
1.
What was the location of your incident (city)?
2.
Name (optional)
3.
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
4.
What language do you mainly speak at home?
English
Spanish
Chinese
Russian
Vietnamese
Other (please specify)
5.
What is the date of service requested? (optional)
6.
May we contact you with questions regarding your service?
Yes, via telephone
Yes, via e-mail
No
Telephone number and/or email address
7.
Please indicate whether you agree or disagree with the following statements:
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
a) The Brevard County Fire Rescue team encouraged me to be transported to the hospital.
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
b) The Brevard County Fire Rescue team treated me with courtesy and respect.
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
c) The Brevard County Fire Rescue team showed concern for my safety and comfort during transport.
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
d) Brevard County Fire Rescue responded to my emergency in a prompt, timely fashion.
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
e) Based on my experience, I would recommend Brevard County Fire Rescue to my friends and family.
Strongly Agree
Agree
Somewhat Agree
Disagree
Strongly Disagree
N/A
Comments (optional)
8.
Please read the following statements regarding your recent experience with Brevard County Fire Rescue. Click the answer that best describes your experience.
Excellent
Very Good
Good
Fair
Poor
N/A
a) Please rate your overall level of satisfaction with Brevard County Fire Rescue.
Excellent
Very Good
Good
Fair
Poor
N/A
b) Please rate your opinion of the emergency medical care provided by Brevard County Fire Rescue.
Excellent
Very Good
Good
Fair
Poor
N/A
c) Please rate the appearance of the Brevard County Fire Rescue team.
Excellent
Very Good
Good
Fair
Poor
N/A
Comments (optional)
9.
If you could change any aspect of Brevard County Fire Rescue, what would you change?