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Patient Satisfaction Questionnaire

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Name:

At which office did you receive your exam?

Bonita Broadway Cay West
Del Prado Estero Lehigh
Naples RPET Winkler
Capri Commons Mobile Mammo

 

Procedure for which you are providing feedback:

CT Mammogram
Nuclear Medicine PET Ultrasound
X-Ray Vein Treatment  
Interventional Procedure Health Screening Other

 

Was this your first visit to Radiology Regional Center? First Time Visitor Previous Patient

 

Who is the doctor that ordered your exam(s)?

 

How did you hear about Radiology Regional Center? Please be specific.

Friend or Family Insurance Plan  
Internet Phone Directory Physician's office

 

 

Please indicate the level of satisfaction that best reflects your experience with
Radiology Regional Center in the following areas:


Process of scheduling your appointment

Excellent Very Good Good Fair

 

Explanation of preparation for your specific test/exam

Very Good Good Fair

 

Efficiency of registration process at the front desk

Very Good Good Fair

 

We are committed to providing service in a timely manner. Please rate your wait time.

Excellent
(shorter than expected)

Very Good
(short wait)
Good
(reasonable)
Fair
(longer than expected)

Poor
(excessively long wait)

 

Explanation of payment and billing procedures

Very Good Good Fair

 

How questions were answered by staff

Very Good Good Fair

 

General appearance and comfort of facility

Very Good Good Fair

 

Did you receive a friendly greeting from each staff member that served you?

No

 

Did each staff member offer you additional assistance before ending their encounter with you?

No

 

What level of hospitality did you receive at Radiology Regional Center?

Excellent Very Good Good Fair Poor

 

Overall experience at Radiology Regional Center

Very Good Good Fair

 

Would you recommend Radiology Regional Center to others?

No

I agree to the terms of the Patient Authorization






 

Contact Us (239) 936-2316

* All Copay, Coinsurance, and Deductible fees are Due at time of Service.

We Accept Cash, Check and Credit Cards:

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Radiology Regional Center - serving the diagnostic needs of Ft. Myers, Cape Coral, Lehigh, Estero, Bonita Springs, and Naples, Florida with X-Ray, MRI, CT, PET, Ultrasound, Digital Mammography, Mobile Mammography, DEXA, Breast Biopsy, Nuclear Medicine & Nuclear Cardiology, Vascular Screenings, Interventional Radiology, Varicose and Spider Vein Treatments, Aesthetic Treatments, and CT Health Screenings.