We want to "C" what you think! (X-ray walk in) Survey

Thank you for choosing Canada Diagnostic Centres as your Radiology provider. To assist us in providing Exceptional Patient Care, we would appreciate a few moments of your time to answer our brief survey.

	Very Satisfied	Satisfied	Dissatisfied	Very Dissatisfied
How satisfied were you with the cleanliness of the clinic?	How satisfied were you with the cleanliness of the clinic? Very Satisfied	How satisfied were you with the cleanliness of the clinic? Satisfied	How satisfied were you with the cleanliness of the clinic? Dissatisfied	How satisfied were you with the cleanliness of the clinic? Very Dissatisfied
How satisfied were you with courtesy and friendliness of the front desk staff?	How satisfied were you with courtesy and friendliness of the front desk staff? Very Satisfied	How satisfied were you with courtesy and friendliness of the front desk staff? Satisfied	How satisfied were you with courtesy and friendliness of the front desk staff? Dissatisfied	How satisfied were you with courtesy and friendliness of the front desk staff? Very Dissatisfied
How satisfied were you with the attention you received from the front desk staff?	How satisfied were you with the attention you received from the front desk staff? Very Satisfied	How satisfied were you with the attention you received from the front desk staff? Satisfied	How satisfied were you with the attention you received from the front desk staff? Dissatisfied	How satisfied were you with the attention you received from the front desk staff? Very Dissatisfied
How satisifed were you with the technologist's explanation of the procedure?	How satisifed were you with the technologist's explanation of the procedure? Very Satisfied	How satisifed were you with the technologist's explanation of the procedure? Satisfied	How satisifed were you with the technologist's explanation of the procedure? Dissatisfied	How satisifed were you with the technologist's explanation of the procedure? Very Dissatisfied
How satisfied were you with the technologist's display of caring and concern for you?	How satisfied were you with the technologist's display of caring and concern for you? Very Satisfied	How satisfied were you with the technologist's display of caring and concern for you? Satisfied	How satisfied were you with the technologist's display of caring and concern for you? Dissatisfied	How satisfied were you with the technologist's display of caring and concern for you? Very Dissatisfied

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

How satisfied were you with the cleanliness of the clinic?

How satisfied were you with the cleanliness of the clinic? Very Satisfied

How satisfied were you with the cleanliness of the clinic? Satisfied

How satisfied were you with the cleanliness of the clinic? Dissatisfied

How satisfied were you with the cleanliness of the clinic? Very Dissatisfied

How satisfied were you with courtesy and friendliness of the front desk staff?

How satisfied were you with courtesy and friendliness of the front desk staff? Very Satisfied

How satisfied were you with courtesy and friendliness of the front desk staff? Satisfied

How satisfied were you with courtesy and friendliness of the front desk staff? Dissatisfied

How satisfied were you with courtesy and friendliness of the front desk staff? Very Dissatisfied

How satisfied were you with the attention you received from the front desk staff?

How satisfied were you with the attention you received from the front desk staff? Very Satisfied

How satisfied were you with the attention you received from the front desk staff? Satisfied

How satisfied were you with the attention you received from the front desk staff? Dissatisfied

How satisfied were you with the attention you received from the front desk staff? Very Dissatisfied

How satisifed were you with the technologist's explanation of the procedure?

How satisifed were you with the technologist's explanation of the procedure? Very Satisfied

How satisifed were you with the technologist's explanation of the procedure? Satisfied

How satisifed were you with the technologist's explanation of the procedure? Dissatisfied

How satisifed were you with the technologist's explanation of the procedure? Very Dissatisfied

How satisfied were you with the technologist's display of caring and concern for you?

How satisfied were you with the technologist's display of caring and concern for you? Very Satisfied

How satisfied were you with the technologist's display of caring and concern for you? Satisfied

How satisfied were you with the technologist's display of caring and concern for you? Dissatisfied

How satisfied were you with the technologist's display of caring and concern for you? Very Dissatisfied

We want to "C" what you think! (X-ray walk in)

Patient Satisfaction Survey Page 1

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* 1. Which clinic did you visit?

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* 2. What day was your exam?

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* 3. Please indicate your level of satisfaction with our clinic staff and service delivery

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* 4. Did the doctor (Radiologist) need to speak with you or perform your procedure?