Patient Survey

***All comments will Remain Confidential***



Teton Radiology (Woodruff Location)
Teton Radiology 3T MRI (Cortez Location)

Tell us your opinion on getting an appointment:
Ease of getting through on the phone Excellent     Good     Fair     Poor    
Courtesy and helpfulness of appointment secretary Excellent     Good     Fair     Poor    
Getting an appointment at the time you wanted Excellent     Good     Fair     Poor    
Tell us your opinion on our practice:
Courtesy and helpfulness of front desk staff Excellent     Good     Fair     Poor    
Explanation of registration forms Excellent     Good     Fair     Poor    
Explanation of billing procedures Excellent     Good     Fair     Poor    
Wait time in the reception area Excellent     Good     Fair     Poor    

Courtesy and helpfulness of nurse (if applicable) Excellent     Good     Fair     Poor    
Courtesy and helpfulness of doctor (if applicable) Excellent     Good     Fair     Poor    

Rate the technologist you saw
Taking enough time with you Excellent     Good     Fair     Poor    
Giving you the information you needed about the exam Excellent     Good     Fair     Poor    
Being careful and helpful Excellent     Good     Fair     Poor    
Tell us your opinion on our facility
Convenient location Excellent     Good     Fair     Poor    
Cleanliness, appearance of office Excellent     Good     Fair     Poor    
Signs helpful in finding where to go Excellent     Good     Fair     Poor    
Dressing area clean, comfortable and private Excellent     Good     Fair     Poor    
Would you recommend our facility to others Excellent     Good     Fair     Poor    

Convenience
Recommendation from friend
Doctor’s choice
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Personal Experience
Other
If you have received bills, give us your feedback
Easy to understand bills Excellent     Good     Fair     Poor    
Courtesy and helpfulness of billing staff Excellent     Good     Fair     Poor