Thank you for choosing the Deaconess Hospital Medical Imaging department for your diagnostic imaging needs. Please take a moment to tell us about your visit today by filling out this brief survey. We would like to know what you thought of your experience. Your opinion is important to us. Let us know how we're doing! Every month we will be drawing names from the returned surveys for a gift card to a local retailer. Fill this out and you might be a winner!

How long did you wait in waiting room before you were taken back for your procedure? 0-10 min
11-20 min
more than 20 min
 
Was the front office staff courteous and helpful? YES
NO
 
Was the hospital staff performing your procedure courteous and caring? YES
NO
 
How did you hear about the Deaconess Hospital Medical Imaging? Billboards
Direct Mailer/Postcard
Radio
Family/Friend
Doctor Referral (Enter Below)
Internet Search (Enter Below)
Other (Enter Below)

 
Would you recommend friends and/or family to the Deaconess Hospital Medical Imaging department for services? YES
NO
 
Other comments
 
You may use my comments and name on the Deaconess website. YES
NO
 
Deaconess Hospital