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Customer Service Survey
Step
1
of
3
33%
Facility
*
Rate the convenience and experience of scheduling an appointment:
*
Poor
Fair
Good
Excellent
Not Applicable
Describe our Employee’s attitude upon arrival:
*
Poor
Fair
Good
Excellent
Not Applicable
Rate the time it took the technologist to arrive:
*
Poor
Fair
Good
Excellent
Not Applicable
Please evaluate our technologist
Professional attitude and appearance:
*
Poor
Fair
Good
Excellent
Relationship with the physicians, supervisors, and staff at your facility:
*
Poor
Fair
Good
Excellent
Rapport with patients
*
Poor
Fair
Good
Excellent
How would you rate our staff’s ability to answer your questions?
*
Poor
Fair
Good
Excellent
Not Applicable
Rate the report turnaround time for STAT exams:
*
Poor
Fair
Good
Excellent
Not Applicable
Did the overall experience of our service exceed your expectation?
*
Yes
No
If you answered NO above, how can we improve our service for you?
Please provide any feedback you may have for Ultra-X Imaging
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