Patient/Family Survey

FLIGHT DISPATCH 1-800-247-5433

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Patient/Family Survey

* Indicates required field

Person completing survey? *

Patient Family Other

If Other please specify: *

Approximate transport Date *

Flight team introduced themselves. *

Strongly Agree Agree Neutral Disagree Strongly Disagree

Flight team were courteous/professional. *

Strongly Agree Agree Neutral Disagree Strongly Disagree

Flight team were knowledgeable and skillfull. *

Strongly Agree Agree Neutral Disagree Strongly Disagree

I felt safe during the transport. *

Strongly Agree Agree Neutral Disagree Strongly Disagree N/A

The flight team kept me informed and my questions were answered. *

Strongly Agree Agree Neutral Disagree Strongly Disagree

I would recommend this flight service in the future. *

Strongly Agree Agree Neutral Disagree Strongly Disagree

Overall rating of your experience with the Med Evac flight team. *

Excellent Very Good Good Ok Bad Terrible

Other comments, suggestions on how Med Evac flight team could have better taken care of you or your family. *

Name *

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Med Evac - 1801 16th St. Greeley, CO 80631 - 1-800-247-5433
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