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You are a “red hot” customer!

Tell us how we can kick it up a notch by completing this survey.

This twelve question survey will provide valuable feedback that will help us provide the best service possible. Thank you for your participation!

SECTION 1: Your experiences and insight.
Please respond to the first five questions based on your experiences ordering MRI and/or PET/CT scans.
At my office, I am directly responsible for ordering MRI or PET/CT scans.*
- YES
- NO
Please explain your role:*
Over the past year, what percentage of your applicable patients have you referred to Shields?*
- 0% - 25%
- 26% - 50%
- 51% - 75%
- 76% - 100%
Over the past year, what percentage of your patients have requested an open MRI?*
- 0% - 25%
- 26% - 50%
- 51% - 75%
- 76% - 100%
Over the past year, what percentage of your patients have inquired about the price of an MRI?*
- 0% - 25%
- 26% - 50%
- 51% - 75%
- 76% - 100%
Regarding Shields Express Link (SEL), our online portal for images, how would you rate your experience?*
- Outstanding
- Satisfactory
- Unsatisfactory
SECTION 2: Compare Shields to other imaging providers.
Please compare the six Shields services below to other providers of MRI or PET/CT (including hospitals) to which you have referred patients. For each component, select either Shields or Competitor, indicating which provides a superior service.
Appointment availability*
- Shields
- Competitor
Ease of scheduling*
- Shields
- Competitor
Customer service*
- Shields
- Competitor
Report turnaround time*
- Shields
- Competitor
Sales support*
- Shields
- Competitor
Availability of latest technology*
- Shields
- Competitor
MRI service overall*
- Shields
- Competitor
SECTION 3: General feedback
Please answer the next two questions with your opinions and feedback.
Would you refer a family member to a Shields MRI facility if they needed an MRI?*
- YES
- NO
Please share why you would not send a family member to Shields MRI.
If you could change one thing about your Shields experience, what would it be?*
Contact Information
The information below will help us keep your identity anonymous, while providing us information that will help us to identify the regions where we can implement the feedback provided. It will also ensure that your practice is entered in to the raffle drawing to win lunch!
Please select the Shields sales representative for your office.*
Sales representatives are listed alphabetical by first name.
Practice Name:
Your practice name will be entered into the raffle drawing for a lunch from Chipotle! To be entered into the raffle, you must provide this information. The more people from your office who enter, the better the chances!
Please provide your practice address and city.*

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