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COMMENT MODE

Magna LS RecordTrak Client Satisfaction Survey

Survey

Please rate the following aspects of our service

1. How was your experience requesting a Medical Record? *This question is required.

Did Not Meet Expectations	Exceeded Expectations	Met Expectations	Not applicable
Did Not Meet Expectations	Exceeded Expectations	Met Expectations	Not applicable

2. Delivery Time *This question is required.

Did Not Meet Expectations	Exceeded Expectations	Met Expectations	Not applicable
Did Not Meet Expectations	Exceeded Expectations	Met Expectations	Not applicable

3. Which ordering method do you prefer when placing a medical record request? *This question is required.

Please enter an 'other' value for this selection.

4. Based on your experience, would you recommend our record retrieval services to a colleague? *This question is required.

5. How can we make your experience better? (optional)

6. Please tell us about yourself.

First Name

Last Name

Firm

Position

Phone Number

Email Address