Date & time of appointment:

Was this scheduled time convenient for you?

yes no

Which facility did you visit?

- Choose Location - 12 Myrtle St (main office) 545 Medical Ctr Dr (Dubs Cancer Ctr) 692 Murphy Rd - Mobile PET Unit 750 Murphy Rd - Mobile MRI Unit 1107 Crater Lake Ave (adj. to ER dept. at PMMC)

Why did you choose to come to OAI?:

It's close to my home/business

Another patient referred me

My doctor referred me

Telephone listing I saw the ad in the newspaper

Other:

Were you able to find our office without a problem?

yes no

Did you have a map to refer to?

yes no

Were your pre-exam instructions clear?

yes no

Was your payment responsibility fully explained to you?

yes no

How long did it take to get the results from your physician?



Was this an acceptable time frame to you?

yes no

Was the facility comfortable and welcoming?

yes no

If no, please explain why not:

Please rate the following:

Friendly, professional, & compassionate care from the receptionist area:

excellent good average poor

Friendly, professional, & compassionate care from the technologists:

excellent good average poor

Friendly, professional, & compassionate care from the nurse:

excellent good average poor

Friendly, professional, & compassionate care from the radiologist:

excellent good average poor

What is your overall impression of OAI and the services we provide?

excellent good average poor

Do you have any suggestions to help us improve our services?

Name and phone number (optional):