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The Radiology Group Imaging CenterImaging Excellence in the Quad Cities Since 1945



Office Survey
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RG Informational Literature | Office Survey

How Are We Doing?
As a part of our continuing effort to provide the best service to physicians and referring offices, we ask that you fill out this short survey. For your convenience you can either click the link to download a printable version of the survey which you can fax to (563) 359-8726 or complete the form online.

PDF Document Download Office Survey

ONLINE SURVEY FOR PHYSICIANS & REFERRING OFFICES

Practice Name:

 Practice Location:
Your Name:

 Title:
Please list the imaging services you refer to RGIC by frequency (1 = most often; 9 = least).
PET
 Nuclear Medicine
 Mammography
High Field Open MRI
 Ultrasound
 Bone Density
16-Slice CT
 General X-ray
 Fluoroscopy

What is your overall
satisfaction with RGIC?


 How likely are you to
continue sending patients?
How likely are you to send patients
for services other than those
"most often referred"?
 How likely are you to
recommend RGIC to other
referring offices?
How could we improve our service to your office/practice?
Office Manager, RN, ARNP, etc.

 Excellent
5 		4 Average 3 2 Poor
1
1. Response to your questions in a timely
    manner.




2. Professionalism & courteousness of
    physicians & staff.




3. Sensitivity to the needs of your
    office/practice




4. Manner in which service meets your
    expectations




5. Maintenance of an appropriate level of
    contact/communication.




6. Report turnaround time.





Are there any materials we provide that you need?
General Requisition Pads
PET Brochures
PET Ordering Guide
PET Ordering Forms
Information about the RG Imaging Center

 Physician Information
Appointment Cards
Physician Guide
Modality Brochures
Have you/staff ever had a tour of the RG Imaging Center? Yes No

Would you/staff be interested in a tour? Yes No

Would you/staff be interested in attending an
informational meeting about scheduling, test Yes No
ordering, insurance issues, etc?
Who is responsible for deciding where to schedule your patients for imaging services?
PhysiciansOffice ManagerNurseSecretaryPatients

Do your physicians request to see a copy of films/images? Yes No

If you send your patients to other imaging facilities, why?
ConvenienceFaster ServiceImage Quality
Other (please explain below)
Scheduler

 Excellent
5 		4 Average 3 2 Poor
1
1. Professionalism & courteousness of
    appointment staff.




2. Speed with which your calls are
    answered.




3. Ability to schedule appointments in a
    timely manner






Comments?


Additional comments/feedback regarding our technologists,schedulers, marketing manager, billing office, etc?


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