Patient Survey

June 17, 2021
What is the patient's name?
When you arrived at the office, were you immediately acknowledged by the reception staff?
Where you treated courteously by the reception staff?
Did you have to wait beyond the scheduled time of your appointment?
If you answered Yes to the previous question, how long did you wait?
If you were a 'walk-in' patient, how long did you have to wait before you could have the x-ray performed?
Were you treated courteously by the technician performing the study? 
Were you easily able to understand the instructions given by the technician regarding your study?
When you scheduled your appointment, was the person courteous and polite? 
If you had to be put on hold, how long was the wait time?
Your Name: