What is your connection to the Hatzola call? --Please Select-- Patient Parent of child patient Relative Friend

Did you receive or witness care from Hatzola? --Please Select-- Yes No

Do you feel the Hatzola team listened to you during the call? --Please Select-- Definitely Somewhat No

Do you feel appropriate treatment was given? --Please Select-- Definitely Somewhat No

On a scale of 1 - 5, how would you rate the call operator? --Please Select-- 1 (Very Dissatisfied) 2 3 4 5 (Very Satisfied) --------------- Can't Say

On a scale of 1 - 5, how would you rate the response time? <--Please Select-- 1 (Very Dissatisfied) 2 3 4 5 (Very Satisfied) --------------- Can't Say

On a scale of 1 - 5, how would you rate the quality of care received? --Please Select-- 1 (Very Dissatisfied) 2 3 4 5 (Very Satisfied) --------------- Can't Say

On a scale of 1 - 5, how would you rate the compassion and care of the Hatzola team? --Please Select-- 1 (Very Dissatisfied) 2 3 4 5 (Very Satisfied) --------------- Can't Say

On a scale of 1 - 5, how would you rate the attitude of the Hatzola team? --Please Select-- 1 (Very Dissatisfied) 2 3 4 5 (Very Satisfied) --------------- Can't Say

Would you recommend Hatzola NW to family and friends? --Please Select-- Definitely Somewhat No

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