Patient Survey

Shared Left Border

Thank you for choosing EVDI Medical Imaging (EVDI) for your diagnostic imaging examination.

We constantly monitor the quality of our services and request that you complete this patient survey form to assist us in our evaluation.

Your assistance is greatly appreciated.

I had my exam performed at:

I had the following exam(s):

Bone Densitometry (DEXA)
CT Scan
Fluoroscopy (Barium Studies)
General X-ray
Mammogram
MRI
Nuclear Medicine
Pet
Ultrasound

Scheduling of my exam was done by:

Other (please specify):

If you scheduled your exam, please rate our service.

Excellent		Satisfactory		Needs Improvement
5	4	3	2	1

Preparations for my exam were explained well.

Excellent		Satisfactory		Needs Improvement
5	4	3	2	1

My greeting by the receptionist was professional.

Excellent		Satisfactory		Needs Improvement
5	4	3	2	1

If you had an appointment, did you wait past your appointment time?

Yes

If yes, how long?

minutes.

If you did not have an appointment, how long did you wait?

minutes.

The technologist performing my exam explained the procedure and treated my professionally.

Excellent		Satisfactory		Needs Improvement
5	4	3	2	1

The appearance of the center was professional.

Excellent		Satisfactory		Needs Improvement
5	4	3	2	1

I would return to your center if I required this type of service in the future.

Yes

I heard about your centers from:

Please include additional comments of suggestions in the space below. Your name, phone and address are optional.

Name:
E-Mail:
Address:
Phone:

To Schedule an Exam

Please Call

Centralized Scheduling

(480) 456-9000

Fax (480) 632-1153

| Back |

| Procedures Performed | Prep Instructions & Forms | Billing & Customer Service |

| Notice of Privacy Practice |

Created by EVDI Medical Imaging IS Department

The content of the EVDI Medical Imaging website is provided for informational purposes about EVDI services. This information is not intended to be used for medical diagnosis or treatment. EVDI recommends that you consult with your physician or health care provider for specific health care questions and concerns.