BRAVO Ambulance Survey
Answers marked with a * are required.
 
1.

Are you:


      

 
 
 
2.

Are you:

 





      

 
 
 
3.

Have you (or a family member) needed an ambulance in the past 12 months?


      

 
 
 
4.

Have you (or a family member) called BRAVO in the past 12 months?


      

 
 
 
5.

How many times have you called an ambulance (BRAVO or 911) in the past 12 months for you (or a family member)?




      

 
 
 
6.

If you needed an ambulance, and called BRAVO, why?





      
 
 
 
7.

If you needed an ambulance, and didn’t call BRAVO, why not?





      
 
 
 
8.

What would increase the likelihood of your calling BRAVO in the future? (check all that apply)




      
 
 
 
9.

Where have you seen BRAVO? (check all that apply)





      
 
 
 
10.

Would you ever consider volunteering for BRAVO?


      

 
 
 
11. Would you be in favor of BRAVO providing Advanced life support services?  (This includes cardiac monitoring, intravenous drug administration and advanced airway devices.)

      

 
 
 
12. Would you be more  inclined to call BRAVO if you knew you could get a higher level of pre-hospital care than what BRAVO currently provides with the same quick response times?

      

 
 
 
13. Have you ever visited BRAVO ambulance on their website (www.bravoambulance.org), Facebook, or Twitter?




      
 
 
 
14.

Overall, on a scale of 1 to 5 (5 being great, 1 being the worst), what is your overall impression of BRAVO?





      

 
 
 
15. Any comments or suggestions:
      
 
 
           
 

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