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CT
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Radiation Safety
Satisfaction Survey
Client Name (optional)
Date of Interaction
Staff member name:
Medical Physicist
Ken Coleman
Travis Greene
Charles Dodge
Larry Cumberbatch
Daniel Ciarleglio
Medical Physicist Assistant
Grant Coleman
Patrick Philips
Megan Philips
Brandon Terracino
Nuclear Medicine Technologist
Charlotte Johnson
Keith Carlough
Jeff Adams
Heather Vann
Cory Furniss
Administration
Diane Coleman
Catherine Coleman
Amber Coleman
Rebekah Juarez
Modality
CT
Mammo
NM Gamma
NM PET
NMQC
Rad/Fluoro
Radiation Safety/RSO
Ultrasound
MRI
Shielding
Phone Call
Professionalism and Communication:
How would you rate the professionalism and communication of our staff during their interaction with you and your team?
Excellent
Very Good
Good
Fair
Poor
Comments
Technical Expertise and Problem-Solving:
Did our staff demonstrate adequate technical knowledge and provide effective solutions to meet your needs?
Yes
No
Somewhat
Comments
Timeliness and Efficiency:
Were our services delivered in a timely and efficient manner?
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Comments
Clarity and Quality of Reporting:
How satisfied are you with the clarity and quality of the reports or documentation we provided?
Extremely Satisfied
Very Satisfied
Satisfied
Somewhat Satisfied
Not Satisfied
Comments
Overall Experience and Suggestions for Improvement:
How would you describe your overall experience working with our group? Do you have any suggestions for improvement?
Submit Survey
Please do not fill in this field.
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