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* 1. What was the date of your incident?

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* 2. Where was your incident?

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* 3. What was the nature of your accident?

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* 4. Were you conscious at the incident scene?

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* 5. Were other people involved in the incident?

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* 6. Were you airlifted or taken by land ambulance?

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* 7. Were you conscious during the transfer to hospital?

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* 8. At the time of your incident, were you aware of the medical care provided included the Midlands Air Ambulance Charity (MAAC)?

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* 9. Roughly, how long were you at the incident scene before being transferred to hospital?

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* 10. Did the MAAC aircrew put you at ease?

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* 11. Did the MAAC aircrew tell you what they were doing?

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* 12. How did you find the experience in the helicopter? Please include noises, sights, comfort, smells and temperature. 

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* 13. Did you feel safe in the helicopter?

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* 14. Which hospital were you taken to?

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* 15. What injuries did you sustain?

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* 16. How long did you remain in hospital? 

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* 17. To help raise awareness of MAAC, would you be happy for us to contact you regarding taking part in a case study?

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* 18. Please leave your name if you consented to us contacting you, or type no in the box below to proceed. 

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* 19. Overall, how would you rate your experience with MAAC?

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* 20. In your view, is there any way MAAC can improve its patient experience?

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* 21. Before your incident, did you know MAAC was a charity?

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* 22. Since your incident, have you learnt that MAAC is a charity?

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* 23. Gender of patient

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* 24. Age of patient

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* 25. Nationality

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