Exit this survey Patient Satisfaction Survey Thank you for using one or more of our services (Imaging/X-ray, Lab, Wright Surgery Center) at University Suburban Health Center. We would like to know if we met your expectations and would appreciate your input on how we might improve our services to you. If you have a moment, would you please fill out the survey below? Question Title * 1. Which service(s) did you use? Diagnostic Imaging Lab Wright Surgery Center Other (please specify) Question Title * 2. Date of Service? Question Title * 3. Courtesy of the receptionist in the building's main lobby Excellent Good Needs Improvement Does not apply Comment: Question Title * 4. Sheduling your appointment Excellent Good Needs Improvement Does not apply Comment: Question Title * 5. Registration process at the time of your appointment Excellent Good Needs Improvement Does not apply Comment: Question Title * 6. Courtesy of the person who registered you Excellent Good Needs Improvement Does not apply Comment: Question Title * 7. Courtesy of nurse/tech or plebotomist Excellent Good Needs Improvement Does not apply Comment: Question Title * 8. How well your questions were answered Excellent Good Needs Improvement Does not apply Comment: Question Title * 9. Overall satisfaction Excellent Good Needs Improvement Does not apply Comment: Question Title * 10. If you had contact with our billing staff for the main Lab, Diagnostic Imaging and/or the Wright Surgery Center, were you treated courteously and professionally? Yes No Comment: Question Title * 11. Would you like someone to contact you regarding any issues you may have had during your visit? Yes No Question Title * 12. Contact information Name Telephone: E-mail: Done
