1.) Are you a Gilpin County Resident
2.) Have you or a family member received emergency services by Gilpin Ambulance Authority any time on or after January 1, 2010?
3.) Are you Male or Female?
4.) How old are you?
5.) Do you feel Gilpin Ambulance Authority is active in the community?
6.) How relevant was the information in the year end report to you?
7.) Was the information in the year end report:
8.) What did you think of the quality of the information in the year end report?
9.) Overall impression for the year end report for Gilpin Ambulance Authority:
500 characters or less.
10.) Would you like Gilpin Ambulance Authority to continue to provide these reports yearly?
11.) Overall impression of Gilpin Ambulance Authority:
12.) Comments & Suggestions
1000 characters or less.