Referring Physician Survey

Referring Physician Survey: Help Us Improve Your Experience

Physician Name *

Office Address *

Select Location *

1. How long have you referred patients to this facility? *

3. How satisfied are you with how long it generally takes to obtain written results (a written consultation) from this facility, once your patient is seen? *

4. How satisfied are you with how long it generally takes to get an oral report from this facility when it is required because of an urgent or emergency situation, once your patient is seen? *

5. How often do you speak to a physician at the IHF regarding the patient’s clinical condition before your patient receives a diagnostic work-up? *

6. Approximately how many patients have you referred to this facility in the past 6 months? *

7. Do you refer your patients to more than one facility of this type? *

8. What are the reasons you refer patients to this particular facility? (Please circle all that apply.)

Nearer Patient’s home

Has specialized equipment needed for test requested

Turnaround time to receive the results is shortest

Has staff that speak other languages, and thus can better understand my patients

Is able to quickly see patients when feedback is urgently required

Has convenient hours of operation

Quality of the services provided

Other

If other, please describe

10. Have you been dissatisfied with a consult you received from this facility in the past six months? *

11. The waiting period for a test to be done is long. *

12. Requests for consultation are handled promptly. *

13. The facility accommodates patients when the test is urgently required. *

14. The interpreting physician is available to you for consultation. *

15. This facility meets the needs of my patients whose first language is other than English or French. *

16. The recommendations received are useful in patient management. *

17. The recommendations are clearly stated. *

18. The reports received are too wordy. *

19. The consulting physician orders tests in addition to those you requested. *

20. The interpreting physician’s findings are generally consistent with your clinical findings. *

21. Overall, how satisfied are you with the contacts you have had with this facility in the past six months? *

Please feel free to provide any additional comments or share any concerns you may have.

We sincerely appreciate your time and valuable feedback. Thank you for helping us enhance our services and better serve you in the future.

Thank you for your feedback. It has been sent.

There was an error trying to send your message. Please try again later.

Referring Physician Survey

Referring Physician Survey: Help Us Improve Your Experience

Medical Imaging

Services

Surveys