Were you able to make an appointment quickly and easily?...............1 2 3 4 5 

Was the scheduling staff friendly, knowledgeable & helpful?..............1 2 3 4 5 

Upon arrival, was the registration performed quickly and efficiently?....1 2 3 4 5 

How thoroughly was your procedure explained to you?......................1 2 3 4 5 

Do you feel your exam was performed professionally?........................1 2 3 4 5 

If you met with a radiologist, was she/he polite and informative?.........1 2 3 4 5 

Overall, did you find our staff friendly, courteous and attentive?..........1 2 3 4 5 

How would you rate the comfort of the surroundings?........................1 2 3 4 5 

Overall, how would you rate the quality of care you received?.............1 2 3 4 5 

How would you rate your total visit time?........................................1 2 3 4 5 

How would you rate the cleanliness of our facility?............................1 2 3 4 5 

Exam
MAMMOX-RAYCTMRIPET/CTNUCLEAR MEDULTRASOUNDBONE DENSITY

Is there someone you would like to recognize for outstanding service or patient care?

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Date of your exam

Windsong Office Location (Required)Williamsville--55 Spindrift DriveW. Amherst--3950 E. Robinson RoadHamburg--4855 Camp RoadLancaster--4893 Transit RoadW. Seneca--1026 Union Road

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