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* 1. How satisfied are you with the overall experience of your exam?

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* 2. How likely are you to recommend our services to your friends and family?

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* 3. What exam did you have performed? (Please mark all that apply)

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* 4. The staff were professional and friendly:

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* 5. Were you provided with clear instructions during your exam?

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* 6. Do you have any suggestions on how we can improve your experience?

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* 7. Date of visit (optional)

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* 8. Contact information (optional)

Please take an Everyone Shines Here comment card to acknowledge a staff member who deserves recognition.

Thank you for taking the time to fill out our survey so that we may improve our services to our patients. Your suggestions are very important to us.

If you have additional information or concerns please feel free to contact:

Director of Radiology

816-629-2757

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