Diagnostic Imaging Associates

Patient QuestionnaireYour impression of our facility is very important to us. We appreciate you taking the time to complete this questionnaire.

Please check location:
Brandywine
Glasgow
Pike Creek
Omega Imaging & MRI
MRI of Wilmington
Omega Nuclear
Women’s Imaging Center

Please check procedure:
Bone Density
Cat Scan
General X-ray (Digital)
Fluoroscopy
Mammography (Digital)
MRI (Stand-up Open Or Conventional)
Nuclear Study
Ultrasonography (2d, 3d, & 4d)

Were you aware of our other locations and services? yes no

Is this your first visit to Diagnostic Imaging Associates (DIA)? yes no

How did you learn about our services and facilities?
My Doctor
Radio
Newspaper/Magazine
Yellow Pages
Internet
Friend or Relative
Insurance Provider
Other

Did you find our appointment times convenient? yes no
If no, why?

Were you acknowledged immediately upon arriving for your appt? yes no
Please Comment:

If you waited 30 minutes or longer, were you informed of the delay and given an estimation of how much longer it would be? yes no
Please Comment:

As an organization, did we appear:
Organized And Efficient
Average
Disorganized

Would you choose DIA for your future radiology needs? yes no
Please Comment:

Would you recommend DIA to a friend or relative? yes no
Please Comment:

Additional Comments

What was most positive about your experience at DIA?

How could we improve for your next visit?

Our goal is to provide you with the best care in Delaware. Your valuable input will help us to improve and maintain excellent service. You may remain anonymous, however, we would appreciate the opportunity to follow-up on your responses.

If you would like to discuss your visit personally, please call Lyndsay Walcome 302-993-2330 ext 206.

Patient Information (Optional)

First Name: Middle: Last:
Email Address:
Phone: (###) - ### ####