Diagnostics Patient Feedback Form

Which Diagnostic Service did you receive? (select as many as you'd like) *

Laboratory (blood work, ECG, holter)

Diagnostic Imaging (x-ray, CT, Ultrasound, Mammography)

Please rate the following questions regarding your experience at BGH:

My appointment time was convenient. *

I knew where to go when I arrived at the Hospital *

I felt welcomed and respected as a patient throughout my visit. *

My privacy/confidentiality was respected at all times. *

My questions were answered promptly and in a way that I could understand. *

I found the patient area to be comfortable and pleasant. *

The Diagnostic area, and the hospital in general, was clean. *

Using any number from 0 to 10, where 0 is the worst care possible and 10 is the best care possible, what number would you use to rate your experience for this visit? *