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  SENIORCARE EMS | SATISFACTION SURVEY
   
 

Thank you for visiting our website. If you or a family member has recently used any of our services, please take a moment to fill out or customer satisfaction survey. Your participation will help us to continuously improve the quality of our care.

CUSTOMER SATISFACTION SURVEY

 
Date of Service
 Patient First Name
 Patient Last Name
 Facility Name
Your First Name
 Your Last Name
 Relationship To Patient
Home Phone
 Mobile Phone
 Who Referred You?
 Email Address

How Did the SCEMS Crew Treat Pt/Family/Staff?

How Was the Crew’s Uniform Presentation?

  

How Was the Vehicle’s Appearance?

  

Was the Crew Enthusiastic About Their Job?

  

Did the Crew Perform Their Job Quickly and Efficiently?

  

How Well Did the Crew Take Care of Your Property?

  

If You Would Need an Ambulance Again, Would You Use SeniorCare EMS?

Any Comments, Ideas, Suggestions Please Let Us Know.
   
   
BRONX BASE: 855 BRUSH AVENUE, BRONX, NY 10465 | BROOKLYN BASE: 562 WORTMAN AVENUE, BROOKLYN, NY 11208
BUSINESS 718-430-1525 | DISPATCH 718-430-9700 | FAX 718-430-1528