Referring Satisfaction Survey

Very Dissatisfied

Dissatisfied

Very Satisfied

Quality of Images

Accuracy of transcribed reports

Availability of Radiologist to answer questions

Timeliness of reports received

Availability to access patient studies

Delaney Radiology continually strives to maintain the highest level of service and overall professionalism. Your comments, both positive and negative, are valued and appreciated. This survey is specifically for services provided at Delaney Radiology outpatient sites. Thank you for your time in providing your feedback.

Practice Name(Required)

Radiologist and Imaging Services

Scheduling and Referral Process

	Very Dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied	N/A
Ease of scheduling patients
Cooperation/helpfulness of staff
Your call answered in a friendly, professional manner
Timeliness of patients being scheduled
Ease of scheduling STAT exams
Notification of issues/questions on your referrals

Overall Services

Would you be interested in being set up with our PACS Imaging system?
- Yes
- No
- Already have access
Please check only one response.
Would you be interested in being set up with our secure Referring Portal?
- Yes
- No
- Already have access
Please check only one response.
Contact info if you would like to be set up for our PACS or Referral Portal. (Practice Name, Your Name, Contact Number & Email)
How often do you refer to Delaney Radiology?
- Daily
- Weekly
- Monthly
- N/A
Please check only one response.
What services do you mainly refer to at Delaney Radiology?
- CT
- MRI
- Ultrasound
- Mammogram
- Bone Density
- X-Ray
- N/A
Check all that apply.
Phone
This field is for validation purposes and should be left unchanged.