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Patient Satisfaction Survey
Your feedback is important to our ongoing efforts to provide you with the very best service.
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1. When I called to schedule my exam, I was able to speak with someone quickly.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
2. The person who scheduled my exam was helpful and efficient.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
3. When I arrived, the receptionist was courteous and made me feel comfortable.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
4. I was seen at or near my appointment time.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
5. The procedure was fully explained to me.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
6. I was given understandable follow-up instructions.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
7. The medical staff performed my procedure with skill.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
8. I was treated with care and consideration.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
9. Patient responsibility and out of pocket expense clearly explained at time of check-in.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
10. I would recommend Hillsborough Radiology Centers to family and friends.
Strongly agree
Agree
Disagree
Strongly disagree
Does not apply
Additional comments
11. What procedure(s) did you have performed?
Please select all that apply
Mammogram
Ultrasound
DXA Bone Density
MRI Scan
CT Scan
X-Ray
Other
Other (please describe)
12. Why did you choose Hillsborough Radiology Center?
Please select all that apply
Recommended by my doctor
Convenient location
Directed by insurance carrier
Yellow Pages Ad
Recommended by friend/relatives
Newspaper Ad
Reputation for excellence
Radio/TV Spot
Had previous studies here
Website
Other
Other (please describe)
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