Patient Feedback Form

Please take a few minutes to fill out this feedback form on the timeliness and quality of the service you received. Rural Medical Imaging welcomes your feedback and your responses will be kept confidential. Thank you for your participation.

Please Click "Submit Feedback" to send and to automatically receive a copy of your feedback to your email address.


This Patient Feedback Form aims to identify service improvements, increase customer satisfaction, strengthen customer relationships, acknowledge areas of excellence and respond effectively and independently to individual cases of dissatisfaction.