Medical Imaging Northwest | Feedback Form

Feedback Form

Tell us how you feel about today’s medical imaging experience…
you could win a $20 South Hill Mall gift certificate!

What type of exam were you here for?
Date
Rate Your Experience
You were able to schedule an appointment within a reasonable amount of time.
If you were a walk-in patient, you were seen within an acceptable timeframe.
You were greeted & treated courteously by our reception staff.
Your technologist was friendly and helpful.
Overall you felt your experience today was
Do you have one suggestion for what we could have done better?
If you win our South Hill Mall gift certificate drawing, how should we reach you?
Name
Phone
Email

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