Patient Quality Improvement Survey

Your opinion is very important to us.

We would appreciate your taking time to tell us how you felt about your experience at Baptist East Diagnostic Imaging Center.

Thank you in advance,
The management and staff of Baptist East Diagnostic Imaging Center

* 1. How did you learn about us?

* 2. If you learned about us from your physician, please provide your physician's name.

* 3. How would you describe the waiting time after completing your paperwork?

* 4. Were the facilities clean?

* 5. Were all staff members polite?

* 6. Would you recommend Baptist East Diagnostic Imaging Center to another person?

* 7. My overall impression of Baptist East Diagnostic Imaging Center is:

* 8. Did the technician treat you with courtesy and respect?

* 9. Technician Name (optional)

* 11. Please share your feedback regarding our staff, facility and your experience.

* 12. If you provide your name you will be entered in a monthly drawing for a Mark’s Feed Store gift card.

Name, (optional)