Patient Survey - Toronto Ultrasound Imaging

Name

Email Address

Date of visit

Test performed

Waiting TimeHow long you had to wait in the clinic waiting room for your appointment

InstructionsHow well the clinic staff (receptionists, technologists, etc.) told you how to prepare for your test(s) and what to expect both before and/or during the test(s)

Concern and caring by clinic staffcourtesy and respect you were given, friendliness and kindness; how well clinic staff listened to what you had to say; how well the clinic staff understood what you thought was important

PrivacyHow well your privacy was considered, for example, type of gowns used, privacy while changing clothes

Overall Quality of CareHow you evaluate the services you received and the way you were treated

Patient Survey: Quality of Care