East River Medical Imaging Service Questionnaire
For Support Staff

This questionnaire is designed to assess the quality of radiology services provided to you. We appreciate your comments, both positive and negative. For the following questions, please indicate your degree of satisfaction by circling the appropriate number.
Thanks in advance for taking the time to complete this questionnaire.
* required fields
CLERICAL SERVICES
* Phones answered promptly and hold time is minimal
* Availability of appointments
* Level of knowledge/courtesy of scheduling staff
* Level of knowledge/courtesy of precertification/billing office staff
* Receptionist interaction with patients
* Availability of reports
Comments
TECHNICAL SERVICES
* Level of professionalism/knowledge of technical staff
* Technologist interaction with patients
* Policy on film copies
Comments
RADIOLOGISTS
* Interaction with patients
* Availability for consultation
Comments
OVERALL SERVICES
* Days/hours of service
* Delivery/availability of films
* On Line reports/images
* Patient wait time
* Overall rating of facility
Comments
If you were not aware we provide a following service, please check:
On-line reports/films
Images on CD
PET/CT
Open MRI
MR Arthrography
MR Angiography
Virtual Colonoscopy
Coronary CTA
Nuclear Medicine
Are there any insurance plans that you would prefer we participate with?
What changes would you like to see us make to better serve you and your patients?
I need Prep Pads/Insurance List.
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