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Date of Service:
Quality of Services
How often have you used Sacred Heart Med-Transit?
Every day
4 or 5 times a week
3 or fewer times a week
First time
How would you rate our transportation services?
Consistent high quality
Generally good
Quality varies daily
Poor quality
How do you typically get to your destinations?
Taxi
Access Shuttle
Family
Friends
Public Transportation
Other
How would you rate those transportation services?
Consistent high quality
Generally good
Quality varies daily
Poor quality
Service and Environment
How long did you wait for your call to be answered?
Immediate service
Less than 1 minute
1 to 3 minutes
More than 3 minutes
How long did you wait for your transportation driver?
Less than 1 minute
1 to 3 minutes
3 to 5 minutes
More than 5 minutes
How would you rate the staff?
Friendly and helpful
Average
Varies on each visit
Poor service
Was the van clean and comfortable?
Yes
No
Additional Comments
About You (optional)
Name
Address
Phone
Email
May we add you to our mailing list, which offs news and exciting promotions?
Yes
No
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