Dear Friend:

We at Fallon Ambulance Service are always striving to provide the finest in patient safety and comfort. As a 68 year-old family owned and operated company, we pride ourselves in being able to deliver to every one of our patients unmatched quality and compassionate care.

Recently, you have experienced our routine or emergency transportation services. Because we value your opinion, we would greatly appreciate your taking the time to fill out the questionnaire below. Your reply will let us know if the service we have provided to you continues to meet our family's high quality standards.  

Sincerely,
Timothy J. Fallon
President


Required Fields Denoted by *


1. How would you rate the staff?
 
Vehicle Staff Appearance: Attitude: Performance:
       


Call Taker   Interaction: Attitude: Performance:
       


Billing Staff   Interaction: Attitude: Performance:
       


2. How would you rate the vehicle?
 
Appearance: Ride: Comfort:
   


3. Were the actions taken by the crew explained to you in a way that you understood?
 


4. The overall care you received was:
 


5. What is your general impression of Fallon Ambulance?
 


6. Was the service that you requested prompt?
 


7. What service did you use?
 
Ambulance Chair Coach


8. When was the service used?
 
Date  
Time  


9. What was your primary reason for using Fallon Ambulance Service?
 
Called 911 MD/RN Social Worker Insurance
Other


10. What suggestions do you have for improving our services?
 


If you would like us to follow up, please provide the information below.
Name
Address
City            
State
Zip
Phone
E-mail *


 
111 Brook Road, Quincy, MA 02169  |  Ph: 617-745-2100 | Toll Free: 888-FALLON5

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