Customer Satisfaction Survey

At LifeLine EMS, we are committed to delivering exceptional medical transportation services. Our goal is to provide you with the best possible care, and your feedback is vital to achieving this aim. By sharing your experiences through this survey, you contribute to our continuous quality improvement program. We use these valuable insights to refine our services, enhance our clinical practices, and meet and exceed your expectations.

Your candid responses enable us to measure our performance, identify areas for improvement, and ultimately enhance the care we provide to all our patients. We appreciate your time and honesty in completing this survey, as it empowers us to serve you and the community better.

Thank you for choosing LifeLine EMS, where your well-being and satisfaction are our unwavering priorities.

Date Of Service?

MM slash DD slash YYYY

Where was your pickup location?

On a scale of 1 to 10 (1 being poor and 10 being excellent), how would you rate the overall quality of care you received from LifeLine EMS?


Were the EMS providers who attended to you courteous and respectful? Please provide details if you can.

Did the LifeLine EMS staff effectively communicate with you and address your concerns or questions during your transport?

How would you rate the professionalism of the LifeLine EMS team that assisted you during your transport?

Greatly Exceeded ExpectationsExceeded ExpectationsMet ExpectationsWorse than ExpectedFar Less than Expected

Were you satisfied with the cleanliness of the ambulance and equipment used during your transport?

Very DissatisfiedDissatisfiedNeutralSatisfiedVery Satisfied

Did the EMS team handle your transfer and movement to and from the gurney with care and consideration for your comfort?

Did you feel safe and secure during your transportation with LifeLine EMS?

Very SafeSafeNeutralUnsafeVery Unsafe

Were you provided with adequate information about the procedures and steps involved in your transport?

How would you rate the quality of driving, on a scale of 1-10 during your transport, considering safety and comfort?


Would you recommend LifeLine EMS to others in need of medical transportation services?

Were there any particular aspects of the service provided by LifeLine EMS that stood out to you, either positively or negatively?

LifeLine EMS is committed to protecting your information. Your information will be used in accordance with all applicable data privacy laws where we operate, and our own privacy policy as well.