Survey

Patient Satisfaction Survey

Please take a moment to answer a few questions about the service you received during your recent visit.

Using a scale of 1 - 10, with 10 being the highest and 1 being the lowest, please answer the following questions:

1.  Please rate how friendly and helpful the reception staff was.
  




2. Please rate the facility cleanliness and how comfortable it was.



3.  Please rate how friendly and professional your technologist was.



4.  Did the technologist explain the procedure prior to your exam?



5.  Did you feel you had a long wait time in the reception area?

6.  How long was your wait time in minutes?



7.  Do you have any suggestions on how we could improve our      services?



Your Name:

Your Phone:

Imaging Center that you visited:


Type of Exam:


Date of Exam:


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