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* 1. Why did you choose Derry Imaging? (check all that apply)

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* 2. What services did you have today (check all that apply)

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* 3. Which location did you visit for your exam?

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* 4. How would you rate your overall experience with the visit to Derry Imaging today?

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* 5. How likely are you to recommend Derry Imaging to a friend or family member

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* 6. Were you greeted by a friendly receptionist when you checked in? (1=Poor 5= Excellent)

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* 7. Do you feel that the staff/technologist listened to your questions/concerns during your visit? (1=Did not listen 5=Listened carefully)

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* 8. Were you told what to expect including how you will learn the results of your testing? (1=Strongly disagree 5=Strongly agree)

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* 9. Were you aware that Derry Imaging ... (check all that you answer yes)

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* 10. Please share with us any positive comments or areas for improvement. If you would like to be contacted for any reason, please include your name and the best way to reach you. Thank you.

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