Patient Satisfaction Survey

I am...*
Technologist ID
Intake / Insurance Verification
I was contacted promptly after my physician placed the testing order*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The intake representative was professional and caring*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
Scheduling / Appointment Making
Scheduling my appointment was easy*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The scheduler explained the study in a way that was clear and easy to understand*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The scheduler was professional and caring*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
Equipment Setup
The setup technologist contacted me prior to the appointment time*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The setup technologist arrived during the scheduled timeframe*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The setup technologist explained the test instructions in a way that was clear and easy to understand*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The log sheets were easy to understand and use*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The setup technologist was professional and caring*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
Equipment Disconnect / Pick Up
The disconnect technologist arrived during the scheduled timeframe*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The study length was appropriate and correct according to my physician’s orders*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The disconnect technologist explained the next steps and when I should expect my test results*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
The disconnect technologist was professional and caring*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
Overall
I had a positive overall experience*
- Strongly Agree
- Agree
- Somewhat Agree
- Disagree
- Strongly Disagree
- Unknown or Does Not Apply
I would like to be contacted by a patient care representative regarding the testing.
- Yes
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Intake / Insurance Verification

Scheduling / Appointment Making

Equipment Setup

Equipment Disconnect / Pick Up

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