Referrer Practitioner Satisfaction Survey Consent *MIC is committed to continuous improvement. Your opinions are important to us and we look forward to your comments. Thank you in advance for your support and continued referrals.1. Approximately what % of your referrals are made to MIC? *0%10-20%30-40%50-75%100%2. What criteria do you use when choosing a provider’s requisition? *Hours of OperationFirst-available AppointmentLocationOtherCriteria you use when choosing a provider’s requisition *3. Rate MIC and their current level of performance on a scale of 1-5, with 1 needing improvement 3 satisfactory and 5 outstanding.Radiologist sub-specialties/ expertise / ability to handle complex cases *12345Timeliness of reporting/ turn-around time *12345Accuracy of reports *12345Quality of reports *12345Availability of radiologists for consultation *12345Radiology Innovation *12345Overall company communications *12345Service by representatives *12345Education events *123454. Would you recommend a friend or colleague to MIC Medical Imaging? *YesNo5. Would an online booking portal or APP increase your referrals to MIC? *YesNo6. Are you aware MIC has pediatric sub-specialized radiologists? *YesNo7. Would you like to be invited to our next education event? If yes, please leave contact information below. *YesNo8. How would you prefer to hear about new procedures offered at MIC? If by email or text messaging please leave contact information below.Fax memoEmailMailed memoHand delivered memoText message9. How can we improve our service and value to you ? *10. Would you be willing to be part of a practitioner focus group? MIC is hoping to gain a practitioner perspective on their experience with MIC Medical Imaging, with the goal of identifying what is important to practitioners, and where we can improve. *Yes, please leave contact information below.NoIf you would like someone to address your survey responses please complete the following:Name (First and Last) *Clinic Name *Email Address *Phone *DonePlease do not fill in this field.
