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Patient Feedback Survey

Please take a few minutes to tell us about your MIC appointment. MIC is committed to continuous improvement and will use your feedback to help improve our services.
1.Which clinic did you visit?(Required.)
2.How did you book your appointment?(Required.)
3.What type of examination did you have?
4.Please rate your interaction with the following members of the MIC team:(Required.)
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied
N/A
Central Booking Staff
Clinic Reception Staff
Technologist
Nurse
5.If you spent time with one of our radiologists, please rate your interaction
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied
N/A
6.Please indicate your level of satisfaction with our clinic:(Required.)
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied
Convenience of hours
Appointment availability
Amount of time spent in waiting room
Cleanliness and comfort of waiting room
Cleanliness and comfort of exam room
Location
7.What was your overall impression of the services provided by MIC Medical Imaging?
Excellent
Good
Neutral
Poor
8.Any additional comments about experience - care, quality of service etc.
9.Would you like to discuss your responses to this questionnaire?(Required.)
10.If you answered ‘yes’ to question #9, please provide the following information and we will contact you:
Current Progress,
0 of 10 answered