2. Please tell us who you are (optional, but necessary if you would like to be entered to win a $50.00 Kroger gift card).

3. If you know your account number, please enter here.

4. What was the date of transport?

Date of Transport

5. Did you make the 911 call? If no, skip to question # 7.

6. Was the 911 call handled in a prompt, courteous and competent manner?

7. Were you the patient (or) were you present when the ambulance crew transported the patient? If no, skip to question # 13.

8. Did the ambulance crew arrive in a timely manner for your medical condition?

9. Did the ambulance crew act in a concerned and caring manner?

10. Did the ambulance crew clearly explain the procedures they performed?

11. How would you rate the cleanliness of the ambulance?

12. How would you rate the overall quality of care provided for you?

13. Have you had any interactions with our billing company? If no, you have completed this survey.

14. Did the billing company answer your call promptly?

15. If you were put on hold for any reason, how would you rate the hold-times?

16. Was the billing department staff professional, courteous and helpful?

17. How would you rate your overall experience with our billing company?

18. Please give us any additional feedback, we value your comments.