CMH Survey

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Radiology Community Physician Survey

How often do you refer your pediatric patients to Children’s Mercy Hospitals and Clinics for their imaging studies?

	Always
	Most of the time
	Occasionally
	Never

Have you referred your pediatric patients to Children’s Mercy Hospitals and Clinics in the past 6 months for plain film imaging or fluoroscopic examinations (UGI/BE/VCUG)?

	Yes
	No

If you do not refer your pediatric patients to Children’s Mercy Hospital for their imaging studies, why not?

Not convenient location
Too hard to schedule
Takes to long to get an appointment
Discourteous staff
Bad experiences
Difficulty receiving reports

Other:

If you have referred your patients for one of the exams listed in #2, on a scale of 1-5 with 5 being very easy and 1 being very difficult, how easy has it been to schedule your patients?

	1 - very difficult
	2 - difficult
	3 - occasionally difficult
	4 - easy
	5 - very easy

Are you satisfied with the scheduling process for imaging at Children’s Mercy?

	1 - very unsatisfied
	2 - unsatisfied
	3 - occasionally unsatisfied
	4 - satisfied
	5 - very satisfied

If unsatisfied or very unsatisfied, why?

When scheduling a patient, have you been treated courteously?

	Always
	Most always
	Not usually
	Never

Overall, how satisfied are you with the service you and your patient’s receive at Children’s Mercy Hospital’s Radiology Department?

	Very satisfied
	Satisfied
	Neutral
	Dissatisfied
	Very dissatisfied

If dissatisfied or very dissatisfied, why?

In your opinion, how can Children’s Mercy Hospital’s Radiology Dept improve its service?