Southwest Diagnostic Imaging Center

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Patient Satisfaction Survey

Please take a moment to complete this survey. Your answers and comments are appreciated, tabulated, and studied. This data is used to regularly monitor our performance and improve or expand the services we provide. Thank you!

1.	Please describe your level of satisfaction with the scheduling process:
	Very Satisfied	Satisfied	Dissatisfied	Very Dissatisfied
2.	Please describe your level of satisfaction with the check-in process:
	Very Satisfied	Satisfied	Dissatisfied	Very Dissatisfied
3.	How long after you checked in did you wait to be served?
	No Wait Time	10 Minutes	20 Minutes	30 Minutes	Other
4.	What imaging service(s) did you receive?
	MRI CT X-ray Ultrasound Mammography Bone Densitometry Other
5.	Please describe your overall level of satisfaction with our imaging services:
	Very Satisfied	Satisfied	Dissatisfied	Very Dissatisfied
6.	How likely are you to return to SWDIC for future imaging services?
	Very Likely	Likely	Unlikely	Very Unlikely
7.	How likely are you to recommend SWDIC to others?
	Very Likely	Likely	Unlikely	Very Unlikely
8.	How does SWDIC compare with similar services you may have received in the past two years?
	Much Better	Better	Worse	Much Worse	Not Applicable
9.	May we use your comments online?
	Yes	No
10.	What one thing could we do to improve our services?

11.	Comments:

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