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SSR Patient Survey

 

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1. Date of your visit?

Date of your visit?

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2. What was the reason for your visit?

What was the reason for your visit?

3. Your appointment was scheduled efficiently and quickly.

Your appointment was scheduled efficiently and quickly.   Poor Fair Good Excellent

4. You received clear answers to all of your questions.

You received clear answers to all of your questions.   Poor Fair Good Excellent

5. You were shown courtesy and respect by our staff.

You were shown courtesy and respect by our staff.   Poor Fair Good Excellent

6. You were satisfied with how promptly you were seen for your scheduled appointment.

You were satisfied with how promptly you were seen for your scheduled appointment.   Poor Fair Good Excellent

7. If you had a scheduled appointment and were not satisfied with how promptly you were seen, were you informed of a delay?

If you had a scheduled appointment and were not satisfied with how promptly you were seen, were you informed of a delay?   Yes No

8. How can South Sound Radiology improve your next visit?

How can South Sound Radiology improve your next visit?

9. Additional comments?

Additional comments?

10. If you would like a representative from South Sound Radiology to contact you, please provide your name, phone number and/or email.

Thank you for completing the patient survey.

If you would like a representative from South Sound Radiology to contact you, please provide your name, phone number and/or email. Thank you for completing the patient survey.