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Referrer Questionnaire
Referrer Questionnaire
Referrer Questionnaire
Referrer
Post
Fax
Secure Online/Email
How would you prefer to refer patients to us?
How would you prefer to receive reports?
Service
Excellent
Very Good
Average
Poor
Unacceptable
Do you feel the service is of benefit to the community?
Has your patients experience been?
Have you found the accuracy of reporting to be?
Have you found the turnaround from referral to receipt of report to be?
Do you consider the service to be high quality?
Would you recommend our service?
Yes
No
Would you recommend our service?
Are there any areas of the service you feel could be improved?
Do you have any other suggestions to improve the service?
CPD half days
Yes
No
Would you be interested in CPD half days involving lectures and case studies on the diagnosis and treatment of certain conditions?
Name
Contact Number or Email
Main Department Referred to
MRI
PET/CT
X-Ray
Ultrasound
1 Stop Clinics
Feedback Policy
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