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PROVIDER PORTAL

PATIENT SURVEY

We've love to hear your feedback! Please tell us how we did during your most recent appointment.

First Name

Last Name

Appointment Date

How did you find the experience of booking appointments?

PoorFairGoodVery goodExcellent

Were you satisfied with the timing of your appointment?

Were you satisfied with the the interactions with the office team?

Did our technologist arrive within the appointment window?

Yes

No

Was the technologist professional & empathetic to your needs?

Yes

No

Was the technologist able to answer all of your questions?

Yes

No

How satisfied were you with the overall appointment experience?

How likely are you to refer our services to family/friends?

How did you hear about Mas Imaging?

Is there anything we can do to improve the exeperience?

Would you like to provide comments for our team?

Your email

Thanks for your feedback!

© 2022 Mas Imaging Portable Radiology

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Suffolk (631) 551-5101

Nassau (516) 490-9058

NYC (345) 773-3464

90 Arrival Avenue

Suite 105

Ronkonkoma, NY 11779

F. (516) 490-9058

Portable@MasImaging.com

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