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PATIENT SURVEY

Dear Patient,
Please let us know how your recent visit to our office went.
 
1) If you scheduled your appointment by phone, please go to the next question. If your doctor’s office scheduled the appointment, or you were a 'walk-in' patient, please skip to question 4.
 
2) When you scheduled your appointment, was the person courteous and polite?
Yes No
 
3) If you had to be put on hold, how long was the wait time? minutes
 
4) When you arrived at the office, were you immediately acknowledged by the reception staff? Yes No
 
5) Where you treated courteously by the reception staff? Yes No
 
6) Did you have to wait beyond the scheduled time of your appointment?
Yes No if yes, how long? minutes
 
7) If you were a 'walk-in' patient, how long did you have to wait before you could have the x-ray performed? minutes
 
8) Were you treated courteously by the technician performing the study?
Yes No
 
9) Were you easily able to understand the instructions given by the technician regarding your study? Yes No
 
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© 2013 Greenwich Radiological Group
49 Lake Avenue, Greenwich, Connecticut
Office: 203.869.6220 • Fax: 203.869.2672