Provider Satisfaction Survey

We use your feedback to innovate and improve our services. Share your comments here to make a difference for your patients.

NOTE: Are you a patient? Go instead to the Patient Satisfaction Survey to give your feedback.

Practice Name

Please select the RadNet Practice where you scheduled service

Your Office Name

Please enter the name of your office or medical practice.

Your Role

Physician

PA / NP

Office Manager

Referral Coordinator

Other

What is your position in the office?

Primary Imaging Center

Please select the imaging center location where you primarily send patients.

Operations

Questions	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Ease of getting through by phone	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Ease of scheduling an appointment	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Friendliness of staff	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Image quality	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Report turnaround time	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Access to images/reports online	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable

Please rate us on the following using a scale of 1-5

Comments

Radiologists

Questions	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Accuracy / Quality of reports	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Radiologist availability for consultation	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable

Please rate us on the following using a scale of 1-5

Comments

Patient Experience Feedback

Questions	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Customer Service	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Cleanliness of our imaging center	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Location / Access to our imaging center	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable

Please rate us on the following using a scale of 1-5

Comments

Overall

Questions	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
How well do we anticipate your needs	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Likelihood you will refer to our imaging center again	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable
Our service favorably differentiates us from other imaging providers	1 - Poor	2 - Fair	3 - Average	4 - Good	5 - Excellent	Not Applicable

Please rate us on the following using a scale of 1-5

Comments

What is most memorable about our service?

What one thing could we do to enhance our service to your practice?

Other comments?

You may choose to remain anonymous or provide us with identification so we may follow-up on your specific needs.

I would like to be contacted to discuss my specific needs.

Your Name