Satisfaction Survey | Brighton Volunteer Ambulance

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?*

Yes
No

You answered "No" above. Please tell us more.

Was our staff that treated you appropriate and professional?*

Yes
No

You answered "No" above. Please tell us more.

Was there clear communication with you, and/or your family, throughout your care?*

Yes
No

You answered "No" above. Please tell us more.

Were you and/or your family treated with respect?*

Yes
No

You answered "No" above. Please tell us more.

Did our staff listen to you throughout your care?*

Yes
No

You answered "No" above. Please tell us more.

Do you feel our staff understood and tended to your concerns?*

Yes
No

You answered "No" above. Please tell us more.

Do you feel that our staff acted as an advocate for you?*

Yes
No

You answered "no" above. Please tell us more.

Do you feel that our staff was skilled in fulfilling your emergency needs?*

Yes
No

You 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?*

Yes
No

You answered "No" above. Please tell us more.

Did you feel safe and secure during transport?*

Yes
No

Seatbelts utilized, felt protected, etc.

You answered "No" above. Please tell us more.

Was the cleanliness of the Ambulance and Equipment satisfactory?*

Yes
No

You answered "No" above. Please tell us more.

Overall

How satisfied overall with your care from Brighton Volunteer Ambulance are you?*

What 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?*

Yes
No
I don't know

Were you provided with a copy of our "Notice of Privacy Practices"?*

Yes
No

We'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?*

Yes
No

We will only contact you with matters related to the service of Brighton Volunteer Ambulance.

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

THANK YOU!

We truly value your feedback and consistently strive to better our service. This information will be extremely helpful.

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