Patient Satisfaction Survey

Our goal at AAR is to exceed your expectations. Please tell us about your recent visit by answering the questions below. We appreciate your participation and will use your feedback to improve our services.

Patient Name
Date of Service*
Location where services were received*
Name of the doctor who ordered the study
Type of study you had at our office? Check all that apply. *
- CT
- Ultrasound
- Mammogram
- Bone Density (DEXA)
- X-Ray
- Other
Check the level of satisfaction that best reflects your experience with the following aspects of our office
Efficiency of scheduling appointment*
Scheduler was friendly and courteous*
Questions or concerns were addressed to your satisfaction*
Exam preparation instructions were clearly communicated*
Availability of appointments was acceptable*
Receptionist was friendly and courteous*
Technologist was caring and courteous*
Cleanliness and tidiness of office*
Time spent in the waiting room before being called for your exam*
Length of your Wait Time
Overall Experience While in our Office*
Were you told when your physician would receive a report of your examination?*
Would you return to this office or refer a friend?*
If you were dissatisfied in any category, please comment:
Would like to be contacted to discuss your comments, please provide the following information?
Name
Phone
Email Address
Best Time To Call?
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Alexandria Radiology

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Patient Satisfaction Survey

Check the level of satisfaction that best reflects your experience with the following aspects of our office

Patient Information