Patient Survey Name* First Last Date* MM slash DD slash YYYY Examination* Email* Choose a Location*Humber Valley XRay & Ultrasound (HQ)Kipling Heights Diagnostic ImagingPDS Diagnostic ImagingYonge & Eglinton Diagnostic ImagingSt. Clair Diagnostic ImagingCollege Diagnostic ImagingUnionville Diagnostic ImagingSimcoe Diagnostic ImagingDMS XRay & UltrasoundPlease be so kind to complete the questions below. This will help us in our Quality Control and Quality Assessment. We thrive to improve our services in order to better serve you. Did you have any difficulty finding the clinic?* Yes No Did the receptionist attend to you promptly and courteously?* Yes No Did you have to wait a long time for your test? If yes, how long?* Yes No Was the test explained to you properly before it was started?* Yes No Were your questions answered satisfactorily?* Yes No Were you treated with courtesy and respect by the technologists and doctors?* Yes No Was your privacy well protected?* Yes No Did you find the atmosphere of the clinic professional and pleasant?* Yes No Would you recommend the clinic to a friend or family member?* Yes No Do you have any other comments?CAPTCHANameThis field is for validation purposes and should be left unchanged.