q
Welcome to Medical Imaging Erina.
Quality images and comprehensive reports.
Medical Imaging Erina | Feedback Form
348790
page-template,page-template-full_width,page-template-full_width-php,page,page-id-348790,page-child,parent-pageid-342837,eltd-cpt-1.0,ajax_fade,page_not_loaded,,moose-ver-1.7, vertical_menu_with_scroll,smooth_scroll,side_menu_slide_with_content,width_370,blog_installed,wpb-js-composer js-comp-ver-5.0.1,vc_responsive
 

Feedback Form

[]
1 Step 1
First Nameyour first name
Last Nameyour last name
Email Addressyour email address
Dateof appointment
Practice Attended
Staff Name(s)
Rate Your Experience With Us For The Following
Arrival
PoorAverageGoodExcellent
Ease of making appointment
Friendliness and helpfulness of reception staff
Reception cleanliness and comfort (furnishings and design)
Examination
PoorAverageGoodExcellent
Waiting time for examination
Explanation of your procedure
Professionalism and friendliness of Technician
Care and skill of Technician
Post-examination
PoorAverageGoodExcellent
Processing of account
Waiting time for results/films
Overall experience
How do you find the website?
Comments or suggestions
Previous
Next