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North Big Horn Hospital District

Patient Satisfaction Radiology Survey

Your feedback is important.  Please take a few minutes to let us know how we can better service you and your family.
Questions marked with an asterisk (*) are mandatory.

The information you provide is protected and secure.
* Did you have difficulty making your exam appointment?
  If yes, please comment.
* How would you rate the friendliness/courtesy of registration staff (front desk of Hospital)?
* How would you rate the friendliness/courtesy of the Radiology staff?
* Did your test/exam start at your appointment time? Please note that Arrival time and Appointment time are not the same.
  If no, please explain.
* How would you rate the explanation of test by the technologist/staff?
* Did a staff member provide you with any post-test information?
  Is there a particular staff member who made an impression on you, good or bad, that you would like to tell us about?
* Using any number from 1 to 10, where 1 is the worst service possible and 10 is the best possible, what number would you use to rate our Radiology Department’s service? 1     2     3     4     5     6     7     8     9     10    
* Would you recommend our services to others?
  Name and Phone Number (optional):