Survey

The State of Hawaii EMS Services recently treated and transported you to the hospital. We would like to take this opportunity to ask for your feedback on our performance. The information you provide will assist us in continuously improving our quality of service. Our goal is to provide excellent service to every patient we treat. For each question, please check the appropriate answer that corresponds to the level of care you received.

An error has occurred , Please contact your system administrator.

First Name

Last Name

Date of Service*

Valid Date of Service is required

Incident #

EPCR #

Run #

Invoice #

* Denotes required field.