Patient Satisfaction Survey Page 1

Thank you for choosing Canada Diagnostic Centres as your Radiology provider. To assist us in providing Exceptional Patient Care, we would appreciate a few moments of your time to answer our brief survey.

* 2. What day was your exam?

Date
/
/

* 3. What type(s) of exam/procedure did you have? (You may select more than one)

* 4. Please indicate your level of satisfaction with our booking agents and appointment services

  Very Satisfied Satisfied Dissatisfied Very Dissatisfied
How satisfied were you with the courtesy and friendliness of the booking agent?
How satisfied were you with the information you received regarding your appointment from the booking agent?
How satisfied were you with the appointment availability?
How satisfied were you with the  automated reminders you received prior to the date of your appointment?

* 5. Please indicate your level of satisfaction with our clinic staff and service delivery

  Very Satisfied Satisfied Dissatisfied Very Dissatisfied
How satisfied were you with the cleanliness of the clinic?
How satisfied were you with courtesy and friendliness of the front desk staff?
How satisfied were you with the attention you received from the front desk staff?
How satisifed were you with the technologist's explanation of the procedure?
How satisfied were you  with the technologist's display of caring and concern for you?

* 6. Did the doctor (Radiologist) need to speak with you or perform your procedure?

T