Arrival - Did you arrive:
Between 5 - 45 minutes before to your appointment
More than 45 minutes before your appointment
At the time of your appointment
Late for your appointment by more than 15 minutes
Not applicable
Any comments:
Departure - Did you leave:
Without having to wait at all
After a short wait of 5 - 45 minutes
After a long wait of more than 45 minutes
Not applicable
Any comments:
If you had to wait, did you receive an explanation for the wait?
Yes, completely
Yes, to some extent
No
Don't know/can't remember
Not applicable
Any comments:
During your journey did you find the Patient First transport staff reassuring?
Yes, definitely
Yes, to some extent
No
Don't know/can't remember
Not applicable
Any comments:
During your journey did Patient First Transport staff treat you with respect and dignity?
Yes, definitely
Yes, to some extent
No
Don't know/can't remember
Not applicable
Any comments:
During your journey did Patient First Transport staff ensure that you were comfortable and welcome?
Yes, definitely
Yes, to some extent
No
Don't know/can't remember
Not applicable
Any comments:
Was the vehicle used for your journey comfortable and clean?
Yes, definitely
Yes, to some extent
No
Don't know/can't remember
Not applicable
Any comments:
Any other comments:
If you would like Patient First to contact you with regard to any aspect of your journey, please provide your name and contact details below, these details will not be used for any other purposes.
Please indicate the date of you received transport:
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