In our effort to provide the best possible service to the patients who are referred to us, we would appreciate your comments regarding your recent visit to our facility. Please complete this short questionaire and submit it to us. Thank you for your help in improving our service.
At which Open MRI facility did you have your MRI done?
Name of physician who referred you:
How would you rate the greeting you received?
Was your test started in a timely manner?
Was the test adequately explained to you?
Indicate the attitude of the technologist toward you.
How would you rate the overall service you received?
For future services would you request Open MRI?
How did you hear about Open MRI?
We would appreciate any information on our staff or our service, either positive or negative:
Name:
Address:
 
City, State, Zip
Phone: - optional
E-Mail