Patient Satisfaction Survey

I am...*

Technologist ID

Intake / Insurance Verification

I was contacted promptly after my physician placed the testing order*

The intake representative was professional and caring*

Scheduling my appointment was easy*

The scheduler explained the study in a way that was clear and easy to understand*

The scheduler was professional and caring*

The setup technologist contacted me prior to the appointment time*

The setup technologist arrived during the scheduled timeframe*

The setup technologist explained the test instructions in a way that was clear and easy to understand*

The log sheets were easy to understand and use*

The setup technologist was professional and caring*

The disconnect technologist arrived during the scheduled timeframe*

The study length was appropriate and correct according to my physician’s orders*

The disconnect technologist explained the next steps and when I should expect my test results*

The disconnect technologist was professional and caring*

I had a positive overall experience*

I would like to be contacted by a patient care representative regarding the testing.

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