Convalescent Survey

Please complete the PCTS survey below to help us continue to improve our service. Use this scale in determining your response:

1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree

Transfer From

Rate on a scale of 1 (worst) - 5 (best)
Professional interaction with dispatcher
Timely arrival of transport crew or satisfactory explanation provided if delay occurred.
Transport crew's appearance was neat and professional
Transport crew introduced themselves
Courteous/professional crew
Transport crew displayed concern for patient's comfort and safety
Transport crew was knowledgeable and skillful
Rate on a scale of 1 (worst) - 10 (best)
Overall satisfaction

1=Very Dissatisfied, 10=Very Satisfied
I would recommend this transport service in the future.

1=Would Not Recommend, 10=Would Highly Recommend
Your Contact Information (optional)
Did you have concerns with this transport that you would like to be contacted about.