Customer Feedback

The focus of Tri-State Ambulance is to continually provide the communities we serve with the highest level of medical care.  This is not an easy task to accomplish and we greatly value feedback from not only those individuals who have utilized our services, but anyone who would like to assist us in improving our EMS services.

Call or Event Information

Please enter any information known about the call or event.
Please enter the date the call or event occurred.
Please enter the approximate time of the call or event if known.

Ambulance Crew Information

Please enter the names of the ambulance crew if known.
First name of the crew member.
First name of the crew member.
Last name of the crew member.
Last name of the crew member.
5 – Excellent 4 – Above Average 3 – Average 2 – Fair 1 – Poor
Please fill in any details or any additional information.