Oceanport First Aid Squad Official Website
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(732) 544-0864
PATIENT SATISFACTION SURVEY
We are committed to providing the best pre-hospital care
possible. Please take a moment to fill out this card and submit it using the button at the bottom of the page. Persons completing this survery remain completely anonymous. Thank you for helping us help the residents of Oceanport in the future.
The time of your emergency was:
*
Between 12 A.M - 6 A.M.
Between 6 A.M. - 12 P.M.
Between 12 P.M. - 6 P.M.
Between 6 P.M. - 12 A.M.
Please choose any/all that apply.
The day was a...
*
Weekday (Monday - Thursday)
Weekend (Friday - Sunday)
Date of emergency:
*
If so desired, please provide us the date of your emergency.
SPACER
I was treated with dignity and respect.
*
Select One
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Other
If Other please specify:
*
SPACER
I was happy with the service/care I received.
*
Select One
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Other
If Other please specify:
*
Squad members acted in a professional manner.
*
Select One
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Other
If Other please specify:
*
SPACER
Squad members were responsive to my needs
*
Select One
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Other
If Other please specify:
*
SPACER.
I was kept informed throughout the incident.
*
Select One
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Other
If Other please specify:
*
Additional Comments:
*
Submit
✕
