WAS THE CRL WOMEN'S IMAGING STAFF COURTEOUS?
Reception
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
Imaging Staff
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
Radiologist
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
WAS OUR STAFF KNOWLEDGEABLE?
Reception
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
Imaging Staff
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
Radiologist
Not At All
0
1
2
3
4
5
6
7
8
9
Very
10
0 is Not At All, 10 is Very
PLEASE RATE YOUR OVERALL EXPERIENCE?
Poor
0
1
2
3
4
5
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7
8
9
Excellent
10
0 is Poor, 10 is Excellent
WOULD YOU RECOMMEND OUR IMAGING FACILITY TO OTHERS?
Unlikely
0
1
2
3
4
5
6
7
8
9
Very Likely
10
0 is Unlikely, 10 is Very Likely
TYPE OF EXAM?
Routine Mammogram
Diagnostic/Follow-up Mammogram
Ultrasound
Breast Biopsy
DEXA
WHAT PROMPTED YOU TO SCHEDULE WITH OUR OFFICE?
Current Patient
Online Search
Social Media
Friend
Referring Provider
Other
If Other, please explain:
Name (Optional)
First Name
Last Name
Phone Number (Optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Comments
Consulting Radiologists
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