Diagnostic Imaging of Southbury

Patient Satisfaction Survey

1. What exam did you have?

What exam did you have? X-Ray

Ultrasound

Mammogram

MRI

CT Scan

Nuclear Medicine Study

Bone Densitometry (DEXA) Scan

Vein Treatment

2. Is this your first visit to Diagnostic Imaging of Southbury?

Is this your first visit to Diagnostic Imaging of Southbury? Yes

3. Please rate your satisfaction regarding the amount of time you waited in the waiting room, assuming that you arrived at your scheduled appointment time.

Please rate your satisfaction regarding the amount of time you waited in the waiting room, assuming that you arrived at your scheduled appointment time. Less time than expected

Expected amount of time

Longer than expected

4. Please tell us how long you waited in the waiting room before being called back for your exam.

Please tell us how long you waited in the waiting room before being called back for your exam.

5. Please tell us about your experience with:

	Outstanding	Good	Fair	Poor
Our reception staff:	*Please tell us about your experience with: Our reception staff: Outstanding	Our reception staff: Good	Our reception staff: Fair	Our reception staff: Poor
Our reception and registration process:	Our reception and registration process: Outstanding	Our reception and registration process: Good	Our reception and registration process: Fair	Our reception and registration process: Poor
Our technologist (person performing your exam):	Our technologist (person performing your exam): Outstanding	Our technologist (person performing your exam): Good	Our technologist (person performing your exam): Fair	Our technologist (person performing your exam): Poor

6. Did the technologist explain your procedure?

Did the technologist explain your procedure? Yes

7. How did you hear about us?

How did you hear about us? From your doctor

Friend

Family Member

Other (please specify)

8. Would you recommend us to a friend or family member?

Would you recommend us to a friend or family member? Yes

9. How could we improve on today’s experience?

How could we improve on today’s experience?

10. Have you visited other radiology offices in the past?

Have you visited other radiology offices in the past? Yes

If yes, how did today's visit compare to your visit elsewhere?

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