Lifestar-Feedback

Lifestar-Feedback

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Submission Date
MM slash DD slash YYYY
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Submission IP
Flight number or referring agency / facility*
Date of Service
MM slash DD slash YYYY
If you know the names of any crew members involved, please provide that information below
RNs, EMT-Ps
Communications Center
How would you rate your experience with the LIFESTAR Communication Center for arranging this patient transfer?*
n/a Poor Fair Good Very good Excellent
If you arranged transport and it was not an excellent experience, please tell us how we can better improve our services.
When choosing an air medical transport team, how did you determine you would call LIFESTAR?
How would you rate the quality of care given to your patient by the flight crew?*
n/a Poor Fair Good Very good Excellent
How would you rate the overall conduct shown by the flight crew?*
n/a Poor Fair Good Very good Excellent
How likely are you to use LIFESTAR in the future for your transport needs?*
n/a Not likely Likely Very likely
How would you rate your overall experience with LIFESTAR?*
n/a Poor Fair Good Very good Excellent
LIFESTAR greatly appreciates your feedback
Please provide any additional comments to help us better serve you.
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