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Home
About Us
About Us
Our Staff
Services
RAPTOR
911 Ambulances
IFT Ambulances
Event Safety
BLS, ALS and CCT Ambulances
Air Ambulances
Urgent Cares
Telemedicine
Multi-Media
Photos
Videos
Publications
Contact Us
Book a Transport
Directions
Feedback
Employment
Billing
Pay a bill
PCS (Download)
Feedback – Hospital Personnel
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Feedback – Hospital Personnel
Fill the form in below to give us Feeback
Please identify your facility.
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County
Facility Name
If it does not appear in the list above, what is the name of your facility?
Indicate whether your hospital sent or received this patient.
Sending Hospital
Receiving Hospital
Enter the transport date:
Please select the approximate time of the transport:
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AM/PM
Please answer the following:
Our communications personnel were courteous and professional.
Strongly Disagree
2
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5
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7
8
9
Strongly Agree
Our crew arrived on time.
Strongly Disagree
2
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6
7
8
9
Strongly Agree
Our crew was courteous and professional.
Strongly Disagree
2
3
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5
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7
8
9
Strongly Agree
Our crew was knowledgeable and skilled.
Strongly Disagree
2
3
4
5
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7
8
9
Strongly Agree
How likely are you to recommend us to a friend or colleague in the future?
Strongly Disagree
2
3
4
5
6
7
8
9
Strongly Agree
How likely are you to recommend us to a friend or colleague in the future?
What is your position?
MD
RN
RT
Admin/Clerk
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Position (If Other)
Would you like us to contact you?
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