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Dear Patient:
Thank you for visiting Memorial MRI & Diagnostic for your exam. We continually strive to maintain thehighest level of service and professionalism. Your opinion and comments are valued and appreciated.In filling this out, you help us to improve our services for your benefit and other patients as well.
 
 
 
1.) How did you hear about Memorial MRI & Diagnostic? (Select all that apply)
 
Friend
 
Relative
 
Physician Referral
 
Attorney Referral
 
Website/Internet
 
Advertisement
 
Insurance
 
 
 
2.) What exam(s) did you have? (Select all that apply)
 
MRI
 
CT
 
PET/CT
 
X-Ray
 
Mammography
 
Ultrasound
 
Pain Consult/Procedure
 
Other
 
 
 
 
3.) Before your appointment, did you visit our website?
 
Yes
 
No
 
 
 
4.) If yes, what were you looking for when you visited our website?
 
 
Other
 
 
 
 
5.) Making your appointment was easy and efficient.
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
6.) The person who scheduled your appointment was helpful and courteous
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
7.) Appointment availability met your needs.
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
8.) The Insurance Verifications department personnel handled your call courteously.
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
N/A
 
 
 
 
9.) The Insurance Verifications department personnel was helpful and knowledgeable
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
N/A
 
 
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