Thank you for your participation in the survey. It will take approximately 5 minutes to complete. Our goal at Sutter Buttes Imaging is to provide the highest quality imaging services to our patients and your completion of this questionnaire will assist us in improving our services to you.

Your Name

Your E-Mail

1. During your visit to Sutter Buttes Imaging, did someone provide you with a clear explanation of your imaging examination?
Yes, definitelyYes, somewhatNo

2. During your visit, did someone listen to you carefully and answer any questions and concerns you might have had about your imaging examination?
Yes, definitelyYes, somewhatNo

3. During your visit, did someone have crucial information about your medical history ("priors") as it related to the imaging examination to be performed?
Yes, definitelyYes, somewhatNo

4. Do you feel our personnel spent enough time with you during your visit?
Yes, definitelyYes, somewhatNo

5. Were you satisfied with your understanding of who would be responsible for interpreting your imaging examination?
Yes, definitelyYes, somewhatNo

6. Were you satisfied with your understanding of when, and to whom, the results of your imaging examination would be communicated, and how those results would then be communicated to you?
Yes, definitelyYes, somewhatNo

7. Did you ask to meet or speak to a radiologist about the results of your exam?
No, I did not know this was an optionNo, I did not feel it was necessary to meet or speak with a radiologistYes, I wanted to meet or speak with a radiologist, and was able to do soYes, I wanted to meet or speak with a radiologist, but he/she was unavailable

8. Overall, how did you rate the care you received during your most recent visit?
ExcellentVery GoodGoodFairPoorNot applicable

9. Based on your most recent visit, would you recommend Sutter Buttes Imaging to others?
Definitely wouldProbably wouldUnsureProbably notDefinitely notNot applicable

10. In general, how would you rate your overall health?
ExcellentVery GoodGoodFairPoor

11. What is your age?
18 to 2425 to 3435 to 4445 to 5455 to 6465 to 7475 or older

12. Are you male or female?
MaleFemale

13. What is the highest grade or level of school that you have completed?
8th grade or lessSome high school, but did not graduateHigh school graduate or GEDSome college or 2-year degree4-year college graduateMore than 4-year college degree

14. Did someone help you complete this survey?
Yes (If yes, please proceed to Question 15)No

15. How did that person help you? Check all that apply.
Read the questions to meWrote down the answers I gaveAnswered the questions for meTranslated the questions into my languageHelped in some other way

Additional Notes, Ideas or Suggestions?