* 1. Why did you choose Derry Imaging? (check all that apply)

* 2. How would you rate your overall experience with the visit to Derry Imaging today?

* 3. How likely are you to recommend Derry Imaging to a friend or family member

* 4. Were you greeted by a friendly receptionist when you checked in? (1=Poor 5= Excellent)

* 5. Did the staff answer your questions thoroughly and properly? (1=Poor 5=Excellent)

* 6. Do you feel that your technologist listened to your questions/concerns during your visit? (1=Did not listen 5=Listened carefully)

* 7. Were you told what to expect including how you will learn the results of your testing? (1=Strongly disagree 5=Strongly agree)

* 8. What services did you have today? (check all that apply)

* 9. Were you aware that Derry Imaging ... (check all that you answer yes)

* 10. Please share with us any positive comments or areas for improvement. If you would like to be contacted please include your name and the best way to reach you.

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