Take our Online Survey
For appointments call: Central Scheduling 603.230.7274
This survey contains questions regarding your experience at Concord Imaging Center. Results are confidential. Information gathered from this survey will be used to improve our services.
1. When did you visit Concord Imaging Center? Mo. / Yr. 2. How did you hear about us?
3. Which facility did you visit?
Concord Imaging Center - Pillsbury Building Concord Imaging Center - Horseshoe Pond
4. Was this your first visit to this facility?
Yes No
5. Were you taken to the exam room at or before your scheduled appointment time?
Yes No – how many minutes past your appointment time did you wait? N/A – I didn’t have a scheduled appointment (Urgent Care Center)
6. Your age group:
19 years and under 20 – 29 years 30 – 39 years 40 – 49 years 50 – 59 years 60 – 69 years 70 – 79 years 80 years or over
1. Was it easy to schedule your appointment(s)?
2. Were available appointment times convenient for you?
3. Please rate the courtesy and helpfulness of the registration staff
D. Facility
Very Poor
Poor
Fair
Good
Very Good
3. Cleanliness of our facility
1. Friendliness/courtesy of the Technologist
2. Friendliness/courtesy of the Physician/Radiologist (if applicable)
3. Explanations about your procedure given by our staff
4. Was our staff concerned for your comfort?
5. Our staff’s response to your questions and/or concerns
1. Our ability to maintain your privacy
2. Our sensitivity to your needs
3. Our response to your concerns and/or complaints made during your visit
1. Our staff kept you informed of any delays
2. Please rate our overall professional appearance
3. Please rate the staff’s professional behavior
4. How well did our staff work together to provide care?
5. Overall rating of your experience at Concord Imaging Center
6. Would you recommend Concord Imaging Center to others?
Please feel free to write any comments you have (positive or negative) about your experience at the CIC:
Name (Optional): Telephone # (Optional):
