Tell us about your experience with us and enter to win a gift card!

Patient Survey

First Name:

Last Name:

Date of Service:

One winner will be randomly selected each month to receive a $50 Visa Gift card!
Please provide the following information in the event you are selected as a winner:

*1.Did you wait longer than 15 minutes for your scheduled appointment?

*2. Was the staff courteous?

*3. Was the staff attentive & responsive to your needs?

*4.Were you satisfied with the exam experience?

*5.Would you recommend this facility to others?

We appreciate any feed back you are able to provide as we strive to
provide excellent patient service:

Yes No Yes No Yes No Yes No Yes No

How was your MRI experience today?