Patient Survey Form

Based on your visit today, did you receive friendly & efficient service at the front desk? Check one.

Which exam best describes your Visit today? Check all that apply.

Was your technologist friendly & efficient?

We strive to provide top quality patient care & satisfaction. If you have suggestions to help us improve the quality of your care please share:

May we contact you about your visit?


Thank you for choosing Wayne Radiologists, P.A.