* 1. What procedure did you Have at Johnson County Imaging?

* 2. What was the date of your appointment?

Date 
/
/

* 3. How promptly was your initial phone call answered by our staff?

* 4. How courteous was the person who answered the phone?

* 5. How courteous was the person who scheduled your appointment?

* 6. How long did it take to get an appointment?

* 7. How courteous was the receptionist when you checked in?

* 8. How quick and easy was the registration / check-in process?

* 9. How close to your appointment time were you seen by the technologist?

* 10. Did the technologist introduce themselves and explain the procedure?

* 11. How courteous was the technologist who performed your test?

* 12. Please rate your comfort and satisfaction with our exam room.

* 13. Did you speak with the Radiologist before or after your exam/procedure?

* 14. If you did speak with the Radiologist, were you satisfied with the communication and answers to your questions?

* 15. How courteous was the Radiologist?

* 16. Did you have any privacy concerns before, during or after your visit?

* 17. If you had any interaction with our billing company, please rate their performance. Answer N/A if you have not worked with our billing company.

  Poor Average Excellent N/A
Pleasant / Polite
Promptness
Accurate resolution of your issue

* 18. Overall, how would you rate the care you received from Johnson County Imaging?

* 19. How likely is it that you would recommend Johnson County Imaging to a friend or colleague?

Not at all likely
Extremely likely

* 20. Please feel free to add any other comments that you believe will help us improve our services.

* 21. Please share your contact information so we can validate your survey.

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