Patient E-Survey

Why does Southern Berkshire Volunteer Ambulance Squad survey its patients?

Because your opinion matters!

Our goal at SBVAS is to exceed your patient care expectations. We regularly survey our patients to determine what we are doing right – – and what areas could use improvement. The results from this survey are one of our most important patient-satisfaction measurement tools. Reading directly from the patient’s perspective allows us to make meaningful changes not only in our clinical care, but in the way we do our jobs as a whole. The comments we receive from our patients tell a story of their experiences here at SBVAS – a story we want and need to hear.  As a matter of fact, we take the time to read every comment on the surveys.

If you would like to receive a hard copy of the patient satisfaction survey in the mail, please contact us  at 413-528-3632 or contact us here.

Thank you for helping us to provide you with the best possible patient care experience.


Privacy Policy

SBVAS will not sell, trade, rent or release your personal information (name, email address, telephone, etc.) to others without your consent.

This site may contain links to other sites, however SBVAS is not responsible for the privacy practices or the content of such web sites.

We respect and work to protect your privacy. If you have any questions about this privacy statement, the practices of this site, or your dealings with SBVAS you may contact us here. 


Patient Survey

Patient Name (required)

Person Completing Survey (required)

Date of Service (required)

Patient Email (required)

Patient Telephone (required)

Patient Address (required)

Reason for Ambulance (required)

Which age group do you fit into? (required)

What is your gender? (required)

Which hospital were you transported to? (required)

After requesting the ambulance (private or 9-1-1), did SBVAS arrive in a timely fashion? (required)

How would you rate the attitude of the EMTs/Paramedics who helped you? (required)

How would you rate the crew's appearance and hygiene? (required)

How would you rate the cleanliness of the vehicle? (required)

How satisfied were you with the medical treatment you received? (required)

Did the EMTs/Paramedics listen and address all of you and/or your family's concerns? (required)

If applicable, how satisfied were you with your interaction with the billing/office staff?

Overall, how would you say your friends and/or family were treated by SBVAS personnel? (required)

Do you have any questions or comments with respect to your experience with SBVAS?

Would you like to be contacted with respect to your experience with SBVAS?