Emergency Ambulance Service Patient Survey

We would like you to think about your recent experience with the East of England Ambulance Service NHS Trust.

Q1. Overall how was your experience of our service? *

Thinking about the service we provide...

Please confirm whether you are happy for your comments to be made public *
Q2. Whose views are being reported in this questionnaire? *
Q3. Please tell us if you have had contact with any of the following health care providers before contacting the ambulance service for this incident *
Q4. How would you rate the handling of your emergency phone call to the ambulance service? *
Q5. How would you describe the length of time you waited for the ambulance service to arrive? *
Q6. Did the ambulance service staff introduce themselves to you? *
Q7. How would you describe the attitude of the ambulance service staff that you had contact with? *
Q8. Did the ambulance service staff treat you with dignity and respect? *
Q9. Did the ambulance service staff treat you with privacy? *
Q10. Did you feel that you could trust the ambulance service staff? *
Q11. Did the ambulance service staff explain your care and treatment to you in a way that was easy to understand? *
Q12. Did the ambulance service staff give you a choice of treatment? *
Q13. How involved do you feel you were in the decisions made regarding your care? *
Q14. How satisfied with the care received from the ambulance service staff? *
Q15. Did the ambulance service staff make an assessment of your pain? *
Q16. Did the ambulance service staff provide you with any pain relief? *
Q17. How would you describe the comfort of your journey in the ambulance? *

Q18. How would you describe the following?

The appearance of the ambulance service staff. *
The cleanliness of equipment used by ambulance service staff. *
Q19. How would you describe the service you received in relation to your expectations? *
The cleanliness of the interior of the ambulance. *

Equality and Diversity

The following questions are used to obtain demographic information about the patients we serve.

This information can help us plan to meet the needs of the community, to ensure that everyone has equal access to the health care we provide, and that we deliver our service to the same high standard for all our patients.

Completion of this page is entirely voluntary.

What age are you?
What best described your gender?
What is your ethnic group?
Religious beliefs of the patient:
Sexual orientation of the patient:
Do you (the patient) have any of the following disabilities?
Are you married or in a civil partnership?
Are you currently pregnant or have had a child within the last 12 months?
Do you now, or have you ever, considered yourself to be transgender?
Did you require any of the following information in a different format to assist you with access to the service?
Do you feel any of the above strands of diversity may have affected the service you received from the East of England Ambulance Service NHS Trust?
Captcha Test Image

Thank you for taking the time to complete this questionnaire.
The information collated will be used to assist us in improving the services we provide.