Patient Satisfaction Survey

Your opinions matter to us. Please take a few moments to complete the following brief survey to help us accomplish our goal of providing a premium service to the patients of our community.

1. What type of test did you have at MMI? (Please check all that apply)
 Ultrasound X-ray Bone Mineral Density (BMD) Mammogram Nuclear Medicine

2. Why did you decide to have your test(s) done at MMI? (Please check all that apply)
 Doctor’s recommendation A friend/relative’s recommendation I have been at MMI before and was pleased with the service Location was convenient Visited website Short waiting list

3. How easy was it to reach MMI to book an appointment?
 Very easy Somewhat easy Neutral Somewhat difficult Difficult

4. Was an appointment available in a reasonable period of time?
 Agree Somewhat agree Neutral Somewhat disagree Disagree

5. How would you rate the courtesy and efficiency of our registration staff?
 Excellent Good Average Poor Very poor

6. Did the technologist performing your test act in a professional manner and satisfactorily answer all your questions?
 Agree Somewhat agree Neutral Somewhat disagree Disagree

7. Was our facility clean and tidy?
 Yes No

8. How likely would you be to recommend MMI to a friend or relative?
 Very likely Likely Neutral Unlikely Very unlikely

9. What did you like best about your experience at MMI?

10. Do you have any suggestions on how we could improve upon the services we currently provide?

If you would like to be contacted in reference to this survey, please provide your name, phone number and/or email address.


Phone Number


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Thank-you for taking the time to complete this survey. The information on this form is strictly confidential and will be used solely by Merivale Medical Imaging for the purpose of operational quality control.