Welcome to HighField Imaging:FeedBack Survey

We at High Field Imaging realize that it is with your input that we continue to grow and provide better service to our patients. Please take a few minutes to answer the following questions regarding your experience at High Field Imaging.

My Exam was performed at :

The name of my exam was:

Date of the Exam:                                Format:mm/dd//yyyy

Was the person answering the phone courteous and efficient?     Yes No

Were you able to obtain a convenient time for your appointment? Yes No

When you arrived, were you greeted promptly and courteously?   Yes No

Did your waiting time exceed 20 minutes?   Yes No

Did the technologist who performed your exam introduce themselves to you?    Yes No

Did the technologist explain the exam in a way that was easy to understand?     Yes No

Was your comfort considered and attended to?      Yes No

Were all staff members courteous?     Yes No

Did you visit the High Field Imaging website prior to your exam?   Yes No

If so, was the web site helpful in preparing for your exam?        Yes No

On a scale of 1-5, with 5 being the best, how would you rate your experience?

1 2   3 4 5

Do you have suggestions about ways in which High Field Imaging can improve it’s service quality?