1. Website Survey

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* 1. Which location did you visit?

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* 2. Please select the radiology imaging services you received.

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* 3. How did you hear about our facility

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* 4. Was this the first visit to our clinic?

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* 5. Registration and Scheduling

  Very Good Good Fair Poor Very Poor
1. Was the receptionist friendly and knowledgeable?
2. Ease in registering or making your appointment.

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* 6. Your Experience

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1. Was the technologist professional and friendly?
2. Was the information provided clear and complete?
3. Were we sensitive to your comfort and needs?

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* 7. Overall Assessment of Experience and Facility

  Very Good Good Fair Poor Very Poor
1. Was the facility clean and comfortable?
2. Overall rating of the care you received during your visit.
3. Likelihood of recommending our facility to others.

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* 8. Was anyone expecially helpful?

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* 9. Contact Information

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