Patient Satisfaction Survey

Our goal is to provide high quality, compassionate, and convenient radiology services. We are striving to improve the service we offer and welcome your feedback and suggestions. Please take a few minutes to complete this survey about your visit. If you prefer, you may download a paper copy of the form to return by mail or call us with your comments at 615-356-5514. All comments will remain confidential.

1 = No Opinion, 2 = Extremely Unsatisfied, 3 = Unsatisfied, 4 = Satisfied, 5 = Very Satisfied


Your Visit
1. Which office did you visit? *
2. What type of Study or Procedure did you receive?

Scheduling and Reception
3. Were the clinic hours of operation convenient for scheduling your examination or procedure? 1 2 3 4 5
4. Were you greeted by the registration staff in a courteous and friendly manner? 1 2 3 4 5
5. Was the registration staff sensitive and protective of your privacy? 1 2 3 4 5
6. Was your wait in the reception area acceptable? 1 2 3 4 5
7. Was the reception area clean and relaxing? 1 2 3 4 5

Technologists and Nurses
8. Did the technologist or nurse explain your examination and answer your questions thoroughly? 1 2 3 4 5
9. Did the technologist or nurse treat you in a courteous, compassionate and caring manner? 1 2 3 4 5

Physician
10. Who was the physician that completed your study?
11. Did the physician explain your examination and answer your questions thoroughly? 1 2 3 4 5
12. Did the physician treat you in a courteous, compassionate and caring manner? 1 2 3 4 5
13. The discomfort I experienced during the procedure was?
1 = no discomfort, 2= minimal, 3= moderate, 4=severe, 5=unbearable		 1 2 3 4 5

Overall
14. What did you like best about your visit?
Staff Convenience Atmosphere Cleanliness Service
15. What did you like least about your visit?
Staff Convenience Atmosphere Cleanliness Service
16. Would you recommend Premier Radiology to a friend or relative? Yes No

For Technician Only

 

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