Applicant Information Form
Give TUEFRT Feedback
to ensure we provide you with the best care possible
This survey is an opportunity for you to provide TUEFRT with anonymous feedback. For example, It can be used to describe an experience with TUEFRT or how we can provide better assessment/treatment.
How it will be used:
Your feedback is valuable to TUEFRT and provides us with the opportunity to improve our service for others. The TUEFRT Program Director can use this to provide general feedback to the responders or guide training. It could also be used to address feedback with individual responders
You do not need to complete the contact information section if you would prefer to remain anonymous. When completing this survey as anonymous, none of your personal information will be recorded. Comments provided will only be accessible to the TUEFRT administration. Providing specific details can help us address specific issues so if you choose to include identifying information such as: your name, time and date of an incident, description of an incident, the names of responders present, etc., this information will not be shared.
If you have feedback but do not want to provide it here, the TUEFRT administration can be contacted at email@example.com.
If you would like the TUEFRT Program Director to follow up about the incident or feedback with you via email, please include your email here.
Date of Incident
Brief Incident Description
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