Customer Satisfaction Survey

Thank you for visiting our centre recently. We continually strive to monitor the quality of our service to ensure we improve if and where necessary and we would be very grateful if you would please complete this survey.

As a thank you for your time completing and returning this form, we will happily give you a £5.00* discount off any subsequent treatment or service you book with us.

Your Name (please leave blank if you wish to remain anonymous)

Your Email (please leave blank if you wish to remain anonymous)

Date of Birth

Which Centre did you attend?

Which scan, test or service did you attend the centre for?

How did you hear about this is my:?

If other, please state

If you found us via the internet, please state how you found our site (Google search, referral from other website etc.)

Why did you choose to book at this is my: health screening & ultrasound centre?

Was it easy to book your appointment?

Comments

Were directions to the centre easy to follow:

Comments

Name the nearest town or city where you live


Did the information leaflets give you all the details you needed?

Comments

Did you find the clinical staff that did your scan helpful & informative?

Comments

Was the scan results/test results explained to you clearly?

Comments

Would you recommend our service to others?

Comments

How would you rate our service?

Are there any additional comments or suggestions you would like to make?

I am happy for my comments to appear on your website under Client Testimonials or internal newsletters

If Yes to the above, I am also happy for my initials & location to appear next to my comment on your website under Client Testimonials or internal newsletters for example: S. S from Leeds

I would be happy to post my review of your service onto a website such as Facebook or Qype

Review us on Qype

We receive a number of requests from the media including woman’s magazines, TV & Radio, who wish to write or film peoples own personal stories. If this is something that may interest you, please let us know

If you would wish to remain anonymous please tick here:

Please note: In order to qualify for your £5.00 voucher all questions must be answered

*£5.00 discount applies to one completed form submitted per household per service received. It can be used against any additional service one at a time. Discount coupon valid up to 12 months. No cash alternative.

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Part of the Optivi Limited Group
Registered Office: 3rd Floor, 45 Maddox Street, London, W1S 2PE
Company reg no. 7146598

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