Patient Survey

Please take our Patient Survey to let us know how your experience with Radiology Medical Group went.

    I was seen at:*

    Type of Exam:*
    MRIUltrasoundX-RayMammogramCTBone DensityOther

    Physician/Provider that ordered the exam:

    Please rate the registration desk personnel:
    PoorFairAverageGoodExcellent

    Please rate the technologist performing your exam:
    PoorFairAverageGoodExcellent

    Please rate your overall experience:
    PoorFairAverageGoodExcellent

    Would you recommend us to friends?
    YesNo

    Why would you recommend/not recommend us?

    Would you like to recognize anyone specifically?

    How did you hear about us?*
    My PhysicianFriend/FamilyI have been here beforeI saw an adOnline researchOther

    Name*

    Email

    Phone

    May we use you testimonial anonymously?*
    YesNo

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