WIS Patient Questionnaire_2009

WIS Patient Questionnaire_2009_

Please take a moment to complete this questionnaire. Your comments will help WIS (Washington Imaging Services) to continue to provide excellent customer service.

1. What was the date of your exam? (mm/dd/yy)

What was the date of your exam? (mm/dd/yy)

2. At which Washington Imaging site was you exam?

At which Washington Imaging site was you exam? Bellevue

Issaquah

3. Please check the exam(s) you had at our facility today:

Please check the exam(s) you had at our facility today: X-Ray

ULTRASOUND

PET/CT

DEXA (Bone Density)

MRI

4. Did you receive personalized, compassionate, and professional care for your exam(s) today?

	Strongly Disagree	Somewhat Disagree	Uncertain	Somewhat Agree	Strongly Agree
-	Did you receive personalized, compassionate, and professional care for your exam(s) today? - Strongly Disagree	Somewhat Disagree	Uncertain	Somewhat Agree	Strongly Agree

5. Would you recommend WIS to others?

	Definitely Not	Possibly	Yes, Definitely
-	Would you recommend WIS to others? - Definitely Not	Possibly	Yes, Definitely

6. Would you like to provide more specific input about your WIS experience?

Would you like to provide more specific input about your WIS experience? Yes

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