Customer Survey

Please answer the following questions. It will assist us in assuring that we are providing the best possible service to the public. Check the appropriate box that applies to you:

I am a:: *

Which County do you live in or represent: *

Have you utilized services from Med-Van in the past?: *

Do you require transportation for Medical appointments?: *

Does your insurance cover para-transit transportation?: *

How would you rate the services Med-Van provides?: *

Are we timely for appointments that you schedule?: *

How would you rate our drivers?: *

How well do we assist you with your individual needs?: *

How would you rate our vehicles.: *

How would you rate our personnel's driving?: *

How would you rate our personnel's appearance?: *

How would you rate our pricing?: *

Additional Comments::

Name: *

Email: *