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Vein Clinic
Survey
Office Satisfaction Survey
*Note:
All fields marked with an asterisk (*) are required.
Please rate the following, with 5 being best:
Poor
Satisfactory
Excellent
Ease of order form use
1
2
3
4
5
Ease of scheduling
1
2
3
4
5
Appointment times available, timely and convenient for the patient
1
2
3
4
5
IMI locations convenient for the patient
1
2
3
4
5
Radiologist interactions
1
2
3
4
5
Report turnaround
1
2
3
4
5
Satisfaction with report
1
2
3
4
5
Accurate, complete information
1
2
3
4
5
Staff competency/care
1
2
3
4
5
1. Does your office have access to web ambassador software?
Yes
No
If NO and you would like more information please include a contact name and phone number.
2. Are our maps, brochures, patient information sheets, and website useful?
Is there additional information we could provide to you, your patients or office staff?
3. If you refer patients to other imaging centers in the area over IMI, please explain why.
4. How can we improve our services to you, your patients and office staff?
5. Comments:
IMI Downtown Boise | IMI Meridian | St Alphonsus Meridian Health Plaza | Saint Alphonsus Eagle Health Plaza
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