| Type of service received: | |
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| Did the crew arrive in a timely manner? | |
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| The crew was dressed professionally: | |
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| Did the crews introduce themselves? | |
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| Was the crew concerned and caring? | |
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| Procedures were clearly explained | |
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| Crew made you comfortable | |
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| Crew addressed you respectfully | |
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| Treated with dignity at all times | |
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| Treatment was appropriate | |
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| Methods to move you for transport | |
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| Ride to the hospital | |
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| Relief of problem | |
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| Overall quality of care received | |
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| Overall actions of the crew & situation | |
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