Carolinas HealthCare System

MedCenter Air Customer Satisfaction Survey 2012

* Indicates required information

Please provide the following information to help us best serve you.

First Name
Last Name

1. *
Please select your job title from the list below.

If Other, please specify:

2. *
Request Number (if given) or Date of Transport
3. *
Did you arrange this transport with MedCenter Air?
4. *
If you arranged the transport and it was not excellent, please provide a detailed explanation on how we can improve our service.
5. *
Did MedCenter Air provide you with an accurate ETA?
6. *
Did the MedCenter Air team introduce themselves and their roles upon arrival?
7. *
How would you rate MedCenter Air's quality of care given to the patient?
8. *
Please rate how MedCenter Air's team communicates effectively:
9. *
Please rate how MedCenter Air's crew demonstrates a respectful, helpful and courteous attitude:
10. *
How do you rate your overall experience with MedCenter Air?
11. *
How likely are you to use MedCenter Air again for your critical care transport needs?
12. *
What did you like the most about your transport with MedCenter Air?
13. *
What did you like least about your transport with MedCenter Air?
14. *
MedCenter Air greatly appreciates your feedback; if we did not provide excellent service please help us improve to maintain excellence.
Please recognize any MedCenter Air staff for doing an excellent job.