Patient Questionaire

Thank you for coming to Advanced Imaging. It is our philosophy to evaluate our service on a regular basis, to gauge our effectiveness and search for areas that are in need of improvement. Would you please take a few moments to fill out this questionnaire so that we may have an idea of how your visit was handled? Feel free to make additional comments in the space provided. Thank you very much for allowing us to partner in your health care needs.
  • :

  • Do you agree or disagree with the following statements?

  • The personal manner of the staff in the following areas was courteous, respectful, friendly and sensitive, and my concerns were all addressed.

  • I was satisfied with:

  • Optionally include name and telephone number if you would like to be contacted. Thank you!