Submit Your Feedback

Client Satisfaction Survey

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Client Centred Care

The air medical crew was respectful and caring.

Yes
No
N/A

The air medical crew helped me understand my condition and my options for care or treatment.

Yes
No
N/A

The air medical crew answered my questions and provided information when I needed it.

Yes
No
N/A

The air medical crew explained the procedures they performed in a manner that I could understand.

Yes
No
N/A

The air medical crew involved me in making decisions about my care.

Yes
No
N/A

The air medical crew made sure I agreed before starting any treatment or medical procedures.

Yes
No
N/A

Provider Competency

I feel confident in the abilities of the air medical crew who provided my care.

Yes
No
N/A

I feel well-cared for by the air medical crew who provided my care.

Yes
No
N/A

The aircraft is clean and comfortable.

Yes
No
N/A

Infection Control

The air medical crew performed proper hand hygiene or wore gloves before giving me medical care or treatments.

Yes
No
N/A

If any members of our staff were especially helpful, please let us know who they were.

Additional comments or suggestions:

Do you wish to be contacted by ACAA?

No
Yes

*If you would like to fill out a Complaint Form please request additional form from the Air Medical Crew or contact Kimberly Belanger (780) 404-5085.