Q.1
Have you had an imaging exam in the past 12 months? (Xray, CT Scan, MRI, Bone Scan, ultrasound, PET)
*
Yes
No
If you have had another imaging exam not mentioned bove please feel free to share
Q.2
Were you introduced to the Radiologist or did a Radiologist speak to you about your imaging exam and/or results?
Yes
No
Q.3
If a Radiologist was available to discuss your imaging exam would you be interested?
Yes
No
Elaborate as to your preference
Q.4
When do you prefer to be educated about the use of contrast media with imaging exam?
When the imaging exam is ordered
The day of exam, in the room, prior to being given of contrast
Feel free to share other options or rationale
Q.5
Which physician do you feel is best to share your results of the imaging exam with you?
Radiologist
Family physician
Surgeon
Specialist (oncologist, cardiologist, orthopedist, other)
Other:
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