Imaging Queensland Referring doctor's Feedback form Question Title * 1. Which region are you in? (Select your region) * Sunshine Coast Central Queensland Moreton Bay Question Title * 2. How satisfied are you with the following services from Sunshine Coast Radiology: Not at all Satisified Not so Satisfied Somewhat Satisfied Very Satisfied Extremely Satisfied Reports delivery Reports delivery Not at all Satisified Reports delivery Not so Satisfied Reports delivery Somewhat Satisfied Reports delivery Very Satisfied Reports delivery Extremely Satisfied Ease of viewing images online Ease of viewing images online Not at all Satisified Ease of viewing images online Not so Satisfied Ease of viewing images online Somewhat Satisfied Ease of viewing images online Very Satisfied Ease of viewing images online Extremely Satisfied Patient satisfaction Patient satisfaction Not at all Satisified Patient satisfaction Not so Satisfied Patient satisfaction Somewhat Satisfied Patient satisfaction Very Satisfied Patient satisfaction Extremely Satisfied Ease of communication channels with our radiologists Ease of communication channels with our radiologists Not at all Satisified Ease of communication channels with our radiologists Not so Satisfied Ease of communication channels with our radiologists Somewhat Satisfied Ease of communication channels with our radiologists Very Satisfied Ease of communication channels with our radiologists Extremely Satisfied Our Practice Locations Our Practice Locations Not at all Satisified Our Practice Locations Not so Satisfied Our Practice Locations Somewhat Satisfied Our Practice Locations Very Satisfied Our Practice Locations Extremely Satisfied Useful Website information Useful Website information Not at all Satisified Useful Website information Not so Satisfied Useful Website information Somewhat Satisfied Useful Website information Very Satisfied Useful Website information Extremely Satisfied Overall Overall Not at all Satisified Overall Not so Satisfied Overall Somewhat Satisfied Overall Very Satisfied Overall Extremely Satisfied Comments Question Title * 3. How can we improve our services? Question Title * 4. What is you specialty? GP Specialist Dentist surgeon Medical officer Physiotherapist Chiropractor Radiologist Other (please specify) Question Title * 5. Name and contact info (Optional) Name Practice Name Email Address Phone Number Done
