Post Transfer Survey

Ascension Sites > Dell Children's > For Healthcare Professionals > Pediatric Critical Care Transport Team > Post Transfer Survey

Please assist us in improving our service by answering the following questions using the scale below.

  • (Please refer to transport number at bottom of follow up letter.)

  • Strongly Agree = 5, Agree = 4, Neutral = 3, Disagree = 2, Strongly Disagree = 1

  • Pre Transport

  • A. Transport was easy to arrange
  • B. Person triaging the call was polite, respectful and efficient
  • C. I was given an accurate estimated time of arrival

  • Intra Transport

  • A. Transport team treated referring staff respectfully
  • B. Patient was treated appropriately and was packaged efficiently

  • Post Transport

  • A. I received a post transport phone call from the team
  • B. Overall, I am satisfied with this transfer
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  • This field is for validation purposes and should be left unchanged.