REFERRING PHYSICIAN/PRACTITIONER SATISFACTION SURVEY
Your satisfaction with our services is very important to us. To assist us in monitoring the quality of our services, please take a few minutes to complete this questionnaire and return via fax to 4162419138.Thank you very much for your support.
Question (please check mark in the appropriate column) YES NO
Are you satisfied with the way the appointments are arranged?
Are your phone calls attended to promptly and courteously?
Is the requisition easy to follow?
Do you receive verbal reports in appropriate circumstances or when requested?
Are the reports concise and comprehensive?
Are reports received in a timely manner?
Do you find our locations and office hours to be convenient?
Do you require more requisition pads? PDF Hard copy
General Comments/Suggestions for improvement: