Patient Survey: Quality of Care

Home / Patient Survey: Quality of Care

Note: Survey must be site specific.

Please rate the following about your visit to Carmit Diagnostic Imaging in terms of whether they were poor, fair, good, very good, or excellent. Circle the number 1 for poor; 2 for fair; 3 for good; 4 for very good, and 5 if you felt it was excellent. If something doesn’t apply to your visit or you don’t have an opinion, please circle the number 8

Please rate each by circling the number that best describes your opinion.

Thank you for completing this survey. Please double check that you have answered all questions and then place the survey in the envelope provided. Your answers will be kept completely confidential.

Thank you again for your help!

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