Norwalk Radiology & Mammography Center

Patient Satisfaction Survey


Your feed back is very important to us. We appreciate you taking the time to fill this out.
 
1.

Please provide us with your:
Age:
 

  • 50 characters left.
2.

Please provide us with your:
Zip Code:
 

  • 50 characters left.
3.

Which modality are you providing feedback on?

Biopsy
Bone Density
Mammography
Ultrasound
CT Scan
MRI
X-Ray
Vein Therapy
4.

Please check all that apply:
 Yes No N/A   
Was the appointment easy to schedule?   
Was your appointment performed on time?   
If not did you wait longer than 15 minutes?   
Was the wait explained to you?   
Was your procedure explained to you?   
If you had any questions, were you satisfied with the answer(s)?   
Was your experience at NRMC a positive one?   
Would you recommend NRMC to your friends/family?   
5.

How would you rate the professional behavior of the following staff?
 Excellent Good Fair Poor Not Applicable 
Appointment Scheduler
Receptionist
Tech Aids
Technologist
Physician
Other (Please Specify:)
  • Comment:

  • 500 characters left.
6.

Is there a particular employee, or employees, who "went above and beyond" that you would like to recognize?

 

  • 50 characters left.
7.

How could we improve or service to you? 
 

  • 350 characters left.

Thank you for taking the time to provide us with your comments. We will use them to improve our service.