Satisfaction Survey HomeSatisfaction Survey Satisfaction Survey Thank you for taking a moment of your time to fill out this short patient survey.We at Brighton Volunteer Ambulance (BVA) appreciate your feedback and potential opportunity to enhance our service.Did you feel that the time it took BVA to get to you was appropriate?*YesNoYou answered "No" above. Please tell us more.Was our staff that treated you appropriate and professional?*YesNoYou answered "No" above. Please tell us more.Was there clear communication with you, and/or your family, throughout your care?*YesNoYou answered "No" above. Please tell us more.Were you and/or your family treated with respect?*YesNoYou answered "No" above. Please tell us more.Did our staff listen to you throughout your care?*YesNoYou answered "No" above. Please tell us more.Do you feel our staff understood and tended to your concerns?*YesNoYou answered "No" above. Please tell us more.Do you feel that our staff acted as an advocate for you?*YesNoYou answered "no" above. Please tell us more.Do you feel that our staff was skilled in fulfilling your emergency needs?*YesNoYou answered "No" above. Please tell us more.Were you taken to your, or your families hospital of choice, and if not, did they clearly explain why?*YesNoYou answered "No" above. Please tell us more.Did you feel safe and secure during transport?*YesNoSeatbelts utilized, felt protected, etc.You answered "No" above. Please tell us more.Was the cleanliness of the Ambulance and Equipment satisfactory?*YesNoYou answered "No" above. Please tell us more.OverallHow satisfied overall with your care from Brighton Volunteer Ambulance are you?*1- Poor2- Moderately3- Good4- Great5- SuperbWhat is the single most thing that stood out to you or your family?If you would like to specifically call attention to our crew for excellent service, please use this box. What could we do differently or better, to better serve you?Were you asked to sign a Rochester Health Information Exchange (RHIO) for, and do you understand why?*YesNoI don't knowWere you provided with a copy of our "Notice of Privacy Practices"?*YesNoWe'd like to be able to follow up with you in the future.We strive to continually improve our services. Providing contact information will allow us to greatly expand our feedback and capabilities. Do we have permission to contact you?*YesNoWe will only contact you with matters related to the service of Brighton Volunteer Ambulance. NameAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email PhoneTHANK YOU!We truly value your feedback and consistently strive to better our service. This information will be extremely helpful.