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Home
Your Exam
Our Services
About Your Scheduled Exam
B Reading Services
Body Composition
Breast Imaging
Breast Cancer Risk Assessment
CT
Coronary CT Angiography
Interventional Radiology
MRI
Nuclear Medicine
PET/CT
Preventive Screening
Theranostics
Ultrasound
Women's Imaging
X-Ray / Fluoroscopy
Pay Your Bill
Patient Portal
Our Radiologists
Locations
Careers
Appointments
About Us
About Us
Leadership
Our History
Inland Imaging News
What Our Patients Say
Patient Resources
Inland Imaging Professional Services (IIPS)
Inland Imaging, LLC / Inland Imaging Clinical Associates (IILLC / IICA)
IIBA Support Services
Interventional Radiology Consultants
Radiology Futures, LLC (RFLLC)
Nuvodia
InlandRCM
SEARCH
PACMED PATIENT SATISFACTION SURVEY
Please choose one recent exam you would like to evaluate:
*
MRI
CT
CT joint or spine injection
Mammography/Breast Imaging
Ultrasound
Breast Biopsy
At which location did you have the exam?
*
Pacific Medical Centers, Beacon Hill
Pacific Medical Centers, Canyon Park
Diagnostic & Wellness Center for Women, Beacon Hill
How satisfied are you with the overall service and care you received today?
*
Great
Good
Ok
Fair
Poor
Ability to get an appointment when and where you wanted?
*
Great
Good
Ok
Fair
Poor
Friendliness and courtesy shown to you by the receptionist?
*
Great
Good
Ok
Fair
Poor
Wait time between you scheduled appointment and start of your exam (in minutes)?
*
How long was your wait in the waiting room (in minutes)?
*
Concern and respect shown to you by the Technologist or Nurse during your exam?
*
Great
Good
Ok
Fair
Poor
The thoroughness of explanations and instructions for your exam?
*
Great
Good
Ok
Fair
Poor
How likely are you to recommend PacMed to a friend or family member? (1 Not Likely - 10 Extremely Likely)?
*
10
9
8
7
6
5
4
3
2
1
What did we do well during your exam?
What can we do to make your experience overall excellent? What can we do better?
Patient Name
First Name
Last Name
Patient Phone Number
(###)
###
####
Date of Exam
MM
DD
YYYY
Would you like a member of the Customer Service Team to contact you regarding your experience?
Yes
No
Thank you!
