The membership of Lexington Park Volunteer Rescue Squad would like to thank you for taking the opportunity to complete this brief survey. Our crews strive to provide the best care possible to the community and value your input. The information contained in this survey will remain confidential unless written content is received. 

Indicates Required Field

Date & Time of Emergency:		00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23  : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
Location of Emergency:
Responding Unit:		Select Below EMS 39 Utility 38 Utility 39 Ambulance 387 Ambulance 388 Ambulance 389 Ambulance 396 Ambulance 397 Ambulance 398 Ambulance 399 Not Exactly Sure
When you called 911 was the dispatcher helpful:		Select Below No Yes
When called 911 was the dispatcher helpful, if NO please elaborate:
Do you feel that LPVRS and other members of the St. Mary's County EMS System responded to your emergency in a timely manner:		Select Below No Yes
If LPVRS and other members of the St. Mary's County EMS System did NOT respond to your emergency in a timely manner, please elaborate:
How would you rate our care:		Poor Fair Good Excellent
Please rate our Providers on the following attributes
Professional:		Poor Fair Good Excellent
Friendly/Courteous:		Poor Fair Good Excellent
Concerned/Caring:		Poor Fair Good Excellent
Appearance/Dress:		Poor Fair Good Excellent
Knowledgeable/Skilled:		Poor Fair Good Excellent
Did our Providers listen to what you had to say:		Select Below No Yes
If the providers did NOT listen to what you had to say, please elaborate.:
Did you feel confident in the care you received:		Select Below No Yes
If you did NOT feel confident in the care you received, please elaborate:
Did our Providers make you feel better, or relieve some of your pain:		Select Below No Yes
If our Providers did NOT make you feel better, or relieve some of your pain please elaborate:
Is there anything else you'd like to add:
Name:
Relationship to patient:
Contact Number:
Contact Email:
If you stated that you were less then satisfied would you mind if we contacted you via the information above?:		Select Below No Yes
If you have any further questions regarding our service please contact us at customerservice@lpvrs.org.