Laboratory Patient Customer Service Survey

Name (*optional)

First Last

Date of visit (*optional)

Time of Visit

Morning

Midday

Afternoon

Where did you receive your lab services?

Outpatient Lab, Memorial Hospital Gulfport, 4500 13th Street, Gulfport

Outpatient Lab, Memorial Hospital Biloxi, 150 Reynoir Street, Biloxi

Outpatient Lab, Memorial Stone County Hospital, 1434 E. Central Ave., Wiggins

Diamondhead Diagnostic Center, 45000 East Aloha Drive, Diamondhead

Acadian Plaza Diagnostic Center, 12261 Hwy 49N, Gulfport

Cedar Lake Diagnostic Center, 1756 Popp’s Ferry Road, Biloxi

Were you treated in a courteous, professional manner?

3 – Yes, it was satisfactory

2 – Somewhat satisfactory

1 – No, I was not treated in a courteous manner

My wait time for blood collection was:

3 – Less than I expected

2 – Satisfactory, as I expected

1 – Much worse than I expected

My discomfort from the procedure was:

3 – Less discomfort than I expected

2 – Satisfactory, as I expected

1 – Much worse than I expected

Overall, my specimen collection experience was:

3 – Excellent, better than I expected

2 – Satisfactory, as I expected

1 – Unsatisfactory, worse than I expected

Would you refer a friend to this phlebotomy (blood draw) location?

Yes

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