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2. The Garden City Fire Department is interested in hearing from you. We are committed to excellence in both patient care and customer service. Please help us maintain this goal by spending a few moments completing our survey.
   
   Fill out the form below with a ranking of each statement. Please rank the statement with 1 (Strongly Disagree) to 5 (Strongly Agree). If the question does not apply to your situation please choose NA (Not Applicable).
4. Date of Service
6. 1. The 911 dispatcher collected all the necessary information quickly and efficiently.
   -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
8. 2. The 911 dispatcher was helpful and courteous.
   -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
10. 3. I used a cell phone to contact 911.
    -- Select One --YesNo
12. 4. The Fire Department provided a timely response to my emergency call.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
14. 5. The firefighter-paramedics were thorough in assessing my current condition and obtaining my medical history.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
16. 6. The firefighter-paramedics were confident and skillful.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
18. 7. The firefighter-paramedics moved me appropriately and were as gentle as possible.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
20. 8. My pain was managed appropriately.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
22. 9. The firefighter-paramedics were helpful and courteous.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
24. 10. The firefighter-paramedics explained the situation to me and my family members.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
26. 11. All reasonable efforts were made to protect my privacy and dignity.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
28. 12. I would not hesitate to call the Garden City fire Department in case of a medical emergency in a future.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
30. 13. The Garden City Fire Department responded with adequate equipment, personnel and expertise to handle me emergency effectively.
    -- Select One --Not Applicable1 - Strongly Disagree2 - Moderately Disagree3 - Neutral4 - Moderately Agree5 - Strongly Agree
32. Comments
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