St Mary's County Advanced Life Support Patient  Feedback
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What was the Date and Time of the EMS Call? *
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Which Rescue Squad Company was involved? *
What unit was involved
Were you directly involved in the incident? *
How long did you have to wait for EMS to arrive?
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How would you rate the professionalism/appearance of the EMS Provider(s)
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How would you rate the quality of the care you received?
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How would you rate the concern the EMS provider showed for your concern?
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How would you rate the the degree to which the provider explained what he or she was doing?
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Did you feel you were being listened to and heard?
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How would you rate the cleanlinessof the ambulance and equipment?
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How aould you rate your overall satisfaction with the care and treatment your received?
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Please provide details regarding the incident *
Please provide your contact information
Would you like to be contacted regarding the resolution of this concern?
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