Welcome
Marion County Ambulance District
Home
About
About Us
Command Staff
Board Members
Contact
Request an Ambulance For a Event
S.T.A.R.S
S.T.A.R.S Program Information
S.T.A.R.S Application
S.T.A.R.S Events and News
Education
Education
Upcoming Education Opportunities
CEU Opportunities
Education Payment Form
Careers
Apply Online
News
Links
Employee Login
Billing
Patient Satisfaction Survey
Financials / District Information
Paramedic Program Login
Marion County Ambulance Satisfaction Survey
Patient Number
*
Please enter the patient number located on you bill.
Date of Call
*
Please enter the date of call.
Please rate the severity of your pain/problem when the Paramedics first arrived.
*
0
1
2
3
4
5
6
7
8
9
10
Please rate the severity of your pain/problem when you arrived at the Emergency Room.
*
0
1
2
3
4
5
6
7
8
9
10
The Paramedic crew acted in a compassionate and caring manner:
*
Outstanding
Excellent
Average
Fair
Poor
The Paramedic crew presented themselves professionally:
*
Outstanding
Excellent
Average
Fair
Poor
The Paramedic crew clearly explained the care and procedures they were providing and responded to questions:
*
Outstanding
Excellent
Average
Fair
Poor
The paramedic crew was thorough in their examination of your problem:
*
Outstanding
Excellent
Average
Fair
Poor
How well did the crew work together to care for you:
*
Outstanding
Excellent
Average
Fair
Poor
How would you rate the quality of care provided:
*
Outstanding
Excellent
Average
Fair
Poor
Was the ambulance ride comfortable and the unit clean: (if not please explain below)
*
Outstanding
Excellent
Average
Fair
Poor
If you were not completly satisfied with the cleanliness or ride of the ambulance please use the space provided below to explain:
*
Do you feel you received great service for your value:
*
Outstanding
Excellent
Average
Fair
Poor
Please comment on your overall expierience with Marion County Ambulance District:
*
Submit
✕
