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Submitted URL: https://www.surveymonkey.com/tr/v1/te/akU_2BQc2vAhAsa_2B264x1g6_2FpF_2Fhy3EhxbpxJDHYpYZT3PErDK_2Bf6OjNYOPsqZdKwguz2iUBY5RSOjl...
Effective URL: https://www.surveymonkey.com/r/?sm=00xyA6bP7gOWkO7RlaBnCEEsjRq94vDNpvP6n6CaK7vsoBz5dEQw1x_2Bt1huKwTEL
Submission: On April 19 via manual from NZ — Scanned from NZ
Effective URL: https://www.surveymonkey.com/r/?sm=00xyA6bP7gOWkO7RlaBnCEEsjRq94vDNpvP6n6CaK7vsoBz5dEQw1x_2Bt1huKwTEL
Submission: On April 19 via manual from NZ — Scanned from NZ
Form analysis 1 forms found in the DOM
Name: surveyForm — POST
<form name="surveyForm" action="" method="post" enctype="multipart/form-data" novalidate="" data-survey-page-form="">
<div class="questions clearfix">
<div class="question-row clearfix
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<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
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<div id="question-field-183745676" data-qnumber="1" data-qdispnumber="1" data-question-id="183745676" class=" question-open-ended-single qn question single">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-183745676" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 1<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> What Practice(s) do you work from and what is your position within this Practice?</span>
<div id="new-commenting-icon_183745676" data-survey-id="412686829" data-question-id="183745676" data-language-code="en" style="display: inline-block" data-sm-comment-icon="">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_183745676" data-question-id="183745676" data-response="" data-sm-open-single="" maxlength="20000" data-ng="true" data-size="50" data-labeledby="question-title-183745676">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-183745676" id="183745676" aria-required="false" data-sm-open-single="true" maxlength="20000" class="wds-input wds-input--lg qt-input_text text"
name="183745676" size="50" value=""></div>
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<div class="question-row clearfix
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<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
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<div id="question-field-183745672" data-qnumber="2" data-qdispnumber="2" data-question-id="183745672" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183745672" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 2<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> How satisfied are you with the quality of services provided by Breast Institute NZ?</span>
<div id="new-commenting-icon_183745672" data-survey-id="412686829" data-question-id="183745672" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331207197">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745672">
<input id="183745672_1331207197" aria-labelledby="183745672_1331207197_label" name="183745672" type="radio" role="radio" class="radio-button-input " value="1331207197" aria-checked="false">
<label data-sm-radio-button-label="" id="183745672_1331207197_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745672_1331207197">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very satisfied </span>
</label>
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<div class="answer-option-cell" data-answer-id="1331207198">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745672">
<input id="183745672_1331207198" aria-labelledby="183745672_1331207198_label" name="183745672" type="radio" role="radio" class="radio-button-input " value="1331207198" aria-checked="false">
<label data-sm-radio-button-label="" id="183745672_1331207198_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745672_1331207198">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Satisfied </span>
</label>
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<div class="answer-option-cell" data-answer-id="1331207199">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745672">
<input id="183745672_1331207199" aria-labelledby="183745672_1331207199_label" name="183745672" type="radio" role="radio" class="radio-button-input " value="1331207199" aria-checked="false">
<label data-sm-radio-button-label="" id="183745672_1331207199_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745672_1331207199">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Neutral </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207200">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745672">
<input id="183745672_1331207200" aria-labelledby="183745672_1331207200_label" name="183745672" type="radio" role="radio" class="radio-button-input " value="1331207200" aria-checked="false">
<label data-sm-radio-button-label="" id="183745672_1331207200_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745672_1331207200">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Dissatisfied </span>
</label>
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</div>
<div class="answer-option-cell" data-answer-id="1331207201">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745672">
<input id="183745672_1331207201" aria-labelledby="183745672_1331207201_label" name="183745672" type="radio" role="radio" class="radio-button-input " value="1331207201" aria-checked="false">
<label data-sm-radio-button-label="" id="183745672_1331207201_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745672_1331207201">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very dissatisfied </span>
</label>
</div>
</div>
</div>
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<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
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<div id="question-field-183745673" data-qnumber="3" data-qdispnumber="3" data-question-id="183745673" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183745673" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 3<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Please rate the communication you've had with our team, e.g. when phoning reception, speaking with our clinical staff, or via email.</span>
<div id="new-commenting-icon_183745673" data-survey-id="412686829" data-question-id="183745673" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331207202">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745673">
<input id="183745673_1331207202" aria-labelledby="183745673_1331207202_label" name="183745673" type="radio" role="radio" class="radio-button-input " value="1331207202" aria-checked="false">
<label data-sm-radio-button-label="" id="183745673_1331207202_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745673_1331207202">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Excellent </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207203">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745673">
<input id="183745673_1331207203" aria-labelledby="183745673_1331207203_label" name="183745673" type="radio" role="radio" class="radio-button-input " value="1331207203" aria-checked="false">
<label data-sm-radio-button-label="" id="183745673_1331207203_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745673_1331207203">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Good </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207204">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745673">
<input id="183745673_1331207204" aria-labelledby="183745673_1331207204_label" name="183745673" type="radio" role="radio" class="radio-button-input " value="1331207204" aria-checked="false">
<label data-sm-radio-button-label="" id="183745673_1331207204_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745673_1331207204">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Average </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207205">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745673">
<input id="183745673_1331207205" aria-labelledby="183745673_1331207205_label" name="183745673" type="radio" role="radio" class="radio-button-input " value="1331207205" aria-checked="false">
<label data-sm-radio-button-label="" id="183745673_1331207205_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745673_1331207205">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Poor </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207206">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745673">
<input id="183745673_1331207206" aria-labelledby="183745673_1331207206_label" name="183745673" type="radio" role="radio" class="radio-button-input " value="1331207206" aria-checked="false">
<label data-sm-radio-button-label="" id="183745673_1331207206_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745673_1331207206">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very poor </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-183745674" data-qnumber="4" data-qdispnumber="4" data-question-id="183745674" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183745674" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 4<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> How responsive were we in addressing any issues or concerns related to your referrals?</span>
<div id="new-commenting-icon_183745674" data-survey-id="412686829" data-question-id="183745674" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331207207">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745674">
<input id="183745674_1331207207" aria-labelledby="183745674_1331207207_label" name="183745674" type="radio" role="radio" class="radio-button-input " value="1331207207" aria-checked="false">
<label data-sm-radio-button-label="" id="183745674_1331207207_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745674_1331207207">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Extremely responsive </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207208">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745674">
<input id="183745674_1331207208" aria-labelledby="183745674_1331207208_label" name="183745674" type="radio" role="radio" class="radio-button-input " value="1331207208" aria-checked="false">
<label data-sm-radio-button-label="" id="183745674_1331207208_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745674_1331207208">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Responsive </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207209">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745674">
<input id="183745674_1331207209" aria-labelledby="183745674_1331207209_label" name="183745674" type="radio" role="radio" class="radio-button-input " value="1331207209" aria-checked="false">
<label data-sm-radio-button-label="" id="183745674_1331207209_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745674_1331207209">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Moderately responsive </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207210">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745674">
<input id="183745674_1331207210" aria-labelledby="183745674_1331207210_label" name="183745674" type="radio" role="radio" class="radio-button-input " value="1331207210" aria-checked="false">
<label data-sm-radio-button-label="" id="183745674_1331207210_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745674_1331207210">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Not very responsive </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331207211">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183745674">
<input id="183745674_1331207211" aria-labelledby="183745674_1331207211_label" name="183745674" type="radio" role="radio" class="radio-button-input " value="1331207211" aria-checked="false">
<label data-sm-radio-button-label="" id="183745674_1331207211_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183745674_1331207211">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Not responsive at all </span>
</label>
</div>
</div>
</div>
</div>
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</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-183746029" data-qnumber="5" data-qdispnumber="5" data-question-id="183746029" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183746029" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 5<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you receive our reports in a timely manner?</span>
<div id="new-commenting-icon_183746029" data-survey-id="412686829" data-question-id="183746029" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331209650">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746029">
<input id="183746029_1331209650" aria-labelledby="183746029_1331209650_label" name="183746029" type="radio" role="radio" class="radio-button-input " value="1331209650" aria-checked="false">
<label data-sm-radio-button-label="" id="183746029_1331209650_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746029_1331209650">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Always </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331209651">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746029">
<input id="183746029_1331209651" aria-labelledby="183746029_1331209651_label" name="183746029" type="radio" role="radio" class="radio-button-input " value="1331209651" aria-checked="false">
<label data-sm-radio-button-label="" id="183746029_1331209651_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746029_1331209651">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Usually </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331209652">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746029">
<input id="183746029_1331209652" aria-labelledby="183746029_1331209652_label" name="183746029" type="radio" role="radio" class="radio-button-input " value="1331209652" aria-checked="false">
<label data-sm-radio-button-label="" id="183746029_1331209652_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746029_1331209652">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Sometimes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331209653">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746029">
<input id="183746029_1331209653" aria-labelledby="183746029_1331209653_label" name="183746029" type="radio" role="radio" class="radio-button-input " value="1331209653" aria-checked="false">
<label data-sm-radio-button-label="" id="183746029_1331209653_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746029_1331209653">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Rarely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331209654">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746029">
<input id="183746029_1331209654" aria-labelledby="183746029_1331209654_label" name="183746029" type="radio" role="radio" class="radio-button-input " value="1331209654" aria-checked="false">
<label data-sm-radio-button-label="" id="183746029_1331209654_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746029_1331209654">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Never </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184614321" data-qnumber="6" data-qdispnumber="6" data-question-id="184614321" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184614321" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 6<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you have any issues receiving or reading our reports?</span>
<div id="new-commenting-icon_184614321" data-survey-id="412686829" data-question-id="184614321" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337313736">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614321">
<input id="184614321_1337313736" aria-labelledby="184614321_1337313736_label" name="184614321" type="radio" role="radio" class="radio-button-input " value="1337313736" aria-checked="false">
<label data-sm-radio-button-label="" id="184614321_1337313736_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614321_1337313736">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Always </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337313737">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614321">
<input id="184614321_1337313737" aria-labelledby="184614321_1337313737_label" name="184614321" type="radio" role="radio" class="radio-button-input " value="1337313737" aria-checked="false">
<label data-sm-radio-button-label="" id="184614321_1337313737_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614321_1337313737">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Usually </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337313738">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614321">
<input id="184614321_1337313738" aria-labelledby="184614321_1337313738_label" name="184614321" type="radio" role="radio" class="radio-button-input " value="1337313738" aria-checked="false">
<label data-sm-radio-button-label="" id="184614321_1337313738_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614321_1337313738">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Sometimes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337313739">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614321">
<input id="184614321_1337313739" aria-labelledby="184614321_1337313739_label" name="184614321" type="radio" role="radio" class="radio-button-input " value="1337313739" aria-checked="false">
<label data-sm-radio-button-label="" id="184614321_1337313739_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614321_1337313739">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Rarely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337313740">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614321">
<input id="184614321_1337313740" aria-labelledby="184614321_1337313740_label" name="184614321" type="radio" role="radio" class="radio-button-input " value="1337313740" aria-checked="false">
<label data-sm-radio-button-label="" id="184614321_1337313740_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614321_1337313740">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Never </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184615228" data-qnumber="7" data-qdispnumber="7" data-question-id="184615228" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184615228" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 7<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> What is your preferred method of sending referrals to us?</span>
<div id="new-commenting-icon_184615228" data-survey-id="412686829" data-question-id="184615228" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337319480">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615228">
<input id="184615228_1337319480" aria-labelledby="184615228_1337319480_label" name="184615228" type="radio" role="radio" class="radio-button-input " value="1337319480" aria-checked="false">
<label data-sm-radio-button-label="" id="184615228_1337319480_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615228_1337319480">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Electronically EDI/BPAC </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337319481">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615228">
<input id="184615228_1337319481" aria-labelledby="184615228_1337319481_label" name="184615228" type="radio" role="radio" class="radio-button-input " value="1337319481" aria-checked="false">
<label data-sm-radio-button-label="" id="184615228_1337319481_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615228_1337319481">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> ManageMyHealth Portal </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337319482">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615228">
<input id="184615228_1337319482" aria-labelledby="184615228_1337319482_label" name="184615228" type="radio" role="radio" class="radio-button-input " value="1337319482" aria-checked="false">
<label data-sm-radio-button-label="" id="184615228_1337319482_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615228_1337319482">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Hand Written (we have referral pads available for referrers) </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337319483">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615228">
<input id="184615228_1337319483" aria-labelledby="184615228_1337319483_label" name="184615228" type="radio" role="radio" class="radio-button-input " value="1337319483" aria-checked="false">
<label data-sm-radio-button-label="" id="184615228_1337319483_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615228_1337319483">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Online pdf Referral (available to download from our website) </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-183746162" data-qnumber="8" data-qdispnumber="8" data-question-id="183746162" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183746162" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 8<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> What is the feedback like from your patients after their appointment with us?</span>
<div id="new-commenting-icon_183746162" data-survey-id="412686829" data-question-id="183746162" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331210952">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746162">
<input id="183746162_1331210952" aria-labelledby="183746162_1331210952_label" name="183746162" type="radio" role="radio" class="radio-button-input " value="1331210952" aria-checked="false">
<label data-sm-radio-button-label="" id="183746162_1331210952_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746162_1331210952">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very satisfied </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331210953">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746162">
<input id="183746162_1331210953" aria-labelledby="183746162_1331210953_label" name="183746162" type="radio" role="radio" class="radio-button-input " value="1331210953" aria-checked="false">
<label data-sm-radio-button-label="" id="183746162_1331210953_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746162_1331210953">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Satisfied </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331210954">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746162">
<input id="183746162_1331210954" aria-labelledby="183746162_1331210954_label" name="183746162" type="radio" role="radio" class="radio-button-input " value="1331210954" aria-checked="false">
<label data-sm-radio-button-label="" id="183746162_1331210954_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746162_1331210954">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Neither satisfied nor dissatisfied </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331210955">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746162">
<input id="183746162_1331210955" aria-labelledby="183746162_1331210955_label" name="183746162" type="radio" role="radio" class="radio-button-input " value="1331210955" aria-checked="false">
<label data-sm-radio-button-label="" id="183746162_1331210955_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746162_1331210955">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Dissatisfied </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331210956">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746162">
<input id="183746162_1331210956" aria-labelledby="183746162_1331210956_label" name="183746162" type="radio" role="radio" class="radio-button-input " value="1331210956" aria-checked="false">
<label data-sm-radio-button-label="" id="183746162_1331210956_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746162_1331210956">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very dissatisfied </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184614967" data-qnumber="9" data-qdispnumber="9" data-question-id="184614967" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184614967" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 9<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you know that we accept Community Funded referrals?</span>
<div id="new-commenting-icon_184614967" data-survey-id="412686829" data-question-id="184614967" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337317827">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614967">
<input id="184614967_1337317827" aria-labelledby="184614967_1337317827_label" name="184614967" type="radio" role="radio" class="radio-button-input " value="1337317827" aria-checked="false">
<label data-sm-radio-button-label="" id="184614967_1337317827_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614967_1337317827">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Yes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337317828">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614967">
<input id="184614967_1337317828" aria-labelledby="184614967_1337317828_label" name="184614967" type="radio" role="radio" class="radio-button-input " value="1337317828" aria-checked="false">
<label data-sm-radio-button-label="" id="184614967_1337317828_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614967_1337317828">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> No </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184614911" data-qnumber="10" data-qdispnumber="10" data-question-id="184614911" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184614911" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 10<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you know that our radiologist speaks to your patient on the day of their appointment to go over their results? Including their personal breast density reading if mammography is performed.</span>
<div id="new-commenting-icon_184614911" data-survey-id="412686829" data-question-id="184614911" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337317497">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614911">
<input id="184614911_1337317497" aria-labelledby="184614911_1337317497_label" name="184614911" type="radio" role="radio" class="radio-button-input " value="1337317497" aria-checked="false">
<label data-sm-radio-button-label="" id="184614911_1337317497_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614911_1337317497">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Yes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337317498">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614911">
<input id="184614911_1337317498" aria-labelledby="184614911_1337317498_label" name="184614911" type="radio" role="radio" class="radio-button-input " value="1337317498" aria-checked="false">
<label data-sm-radio-button-label="" id="184614911_1337317498_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614911_1337317498">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> No </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-183746491" data-qnumber="11" data-qdispnumber="11" data-question-id="183746491" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-183746491" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 11<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you know that we can perform same day biopsies if deemed necessary by our radiologist and patient consents?</span>
<div id="new-commenting-icon_183746491" data-survey-id="412686829" data-question-id="183746491" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1331212469">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746491">
<input id="183746491_1331212469" aria-labelledby="183746491_1331212469_label" name="183746491" type="radio" role="radio" class="radio-button-input " value="1331212469" aria-checked="false">
<label data-sm-radio-button-label="" id="183746491_1331212469_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746491_1331212469">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Yes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1331212470">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-183746491">
<input id="183746491_1331212470" aria-labelledby="183746491_1331212470_label" name="183746491" type="radio" role="radio" class="radio-button-input " value="1331212470" aria-checked="false">
<label data-sm-radio-button-label="" id="183746491_1331212470_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="183746491_1331212470">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> No </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184614713" data-qnumber="12" data-qdispnumber="12" data-question-id="184614713" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184614713" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 12<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you know that we will contact your patient directly with their lab results, as well as set up a consultation with our onsite breast surgeon if follow up is necessary?</span>
<div id="new-commenting-icon_184614713" data-survey-id="412686829" data-question-id="184614713" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337316146">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614713">
<input id="184614713_1337316146" aria-labelledby="184614713_1337316146_label" name="184614713" type="radio" role="radio" class="radio-button-input " value="1337316146" aria-checked="false">
<label data-sm-radio-button-label="" id="184614713_1337316146_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614713_1337316146">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Yes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337316147">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184614713">
<input id="184614713_1337316147" aria-labelledby="184614713_1337316147_label" name="184614713" type="radio" role="radio" class="radio-button-input " value="1337316147" aria-checked="false">
<label data-sm-radio-button-label="" id="184614713_1337316147_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184614713_1337316147">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> No </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-184615430" data-qnumber="13" data-qdispnumber="13" data-question-id="184615430" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-184615430" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 13<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Do you know that we can perform Contrast Enhanced Mammography? (We are the only clinic to offer this procedure in NZ)</span>
<div id="new-commenting-icon_184615430" data-survey-id="412686829" data-question-id="184615430" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337321117">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615430">
<input id="184615430_1337321117" aria-labelledby="184615430_1337321117_label" name="184615430" type="radio" role="radio" class="radio-button-input " value="1337321117" aria-checked="false">
<label data-sm-radio-button-label="" id="184615430_1337321117_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615430_1337321117">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Yes </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337321118">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615430">
<input id="184615430_1337321118" aria-labelledby="184615430_1337321118_label" name="184615430" type="radio" role="radio" class="radio-button-input " value="1337321118" aria-checked="false">
<label data-sm-radio-button-label="" id="184615430_1337321118_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615430_1337321118">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> No </span>
</label>
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<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
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<div id="question-field-184615508" data-qnumber="14" data-qdispnumber="14" data-question-id="184615508" class=" question-single-choice-radio qn question vertical">
<h3 class="screenreader-only">Question Title</h3>
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<legend class="question-legend">
<h4 id="question-title-184615508" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 14<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> If you did not know about the above services we provide, would you be more likely to refer to us now, knowing this?</span>
<div id="new-commenting-icon_184615508" data-survey-id="412686829" data-question-id="184615508" data-language-code="en" data-sm-comment-icon="" style="display: inline-block">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell" data-answer-id="1337321760">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615508">
<input id="184615508_1337321760" aria-labelledby="184615508_1337321760_label" name="184615508" type="radio" role="radio" class="radio-button-input " value="1337321760" aria-checked="false">
<label data-sm-radio-button-label="" id="184615508_1337321760_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615508_1337321760">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very likely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337321761">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615508">
<input id="184615508_1337321761" aria-labelledby="184615508_1337321761_label" name="184615508" type="radio" role="radio" class="radio-button-input " value="1337321761" aria-checked="false">
<label data-sm-radio-button-label="" id="184615508_1337321761_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615508_1337321761">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Likely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337321762">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615508">
<input id="184615508_1337321762" aria-labelledby="184615508_1337321762_label" name="184615508" type="radio" role="radio" class="radio-button-input " value="1337321762" aria-checked="false">
<label data-sm-radio-button-label="" id="184615508_1337321762_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615508_1337321762">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Neither likely nor unlikely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337321763">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615508">
<input id="184615508_1337321763" aria-labelledby="184615508_1337321763_label" name="184615508" type="radio" role="radio" class="radio-button-input " value="1337321763" aria-checked="false">
<label data-sm-radio-button-label="" id="184615508_1337321763_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615508_1337321763">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Unlikely </span>
</label>
</div>
</div>
<div class="answer-option-cell" data-answer-id="1337321764">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-184615508">
<input id="184615508_1337321764" aria-labelledby="184615508_1337321764_label" name="184615508" type="radio" role="radio" class="radio-button-input " value="1337321764" aria-checked="false">
<label data-sm-radio-button-label="" id="184615508_1337321764_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="184615508_1337321764">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Very unlikely </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="open_ended_essay" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-183746783" data-qnumber="15" data-qdispnumber="15" data-question-id="183746783" class=" question-essay qn question essay">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-183746783" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 15<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Would you like more information about the Breast Institute NZ and our services? We can drop off pamphlets and posters to your Practice and/or we can organise for one of our clinical staff members to speak at your next staff
meeting or peer review study day.</span>
<div id="new-commenting-icon_183746783" data-survey-id="412686829" data-question-id="183746783" data-language-code="en" style="display: inline-block" data-sm-comment-icon="">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
<div class="question-body clearfix notranslate ">
<div class="textarea-container">
<textarea aria-labelledby="question-title-183746783" id="183746783" name="183746783" class="textarea" spellcheck="true" rows="3" cols="50" data-sm-textarea="" maxlength="20000"></textarea>
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</div>
<div class="question-row clearfix
">
<div data-question-type="open_ended_essay" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-183746659" data-qnumber="16" data-qdispnumber="16" data-question-id="183746659" class=" question-essay qn question essay">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-183746659" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 16<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Is there anything we could be doing better? This could specific to how we interact with your particular Practice.</span>
<div id="new-commenting-icon_183746659" data-survey-id="412686829" data-question-id="183746659" data-language-code="en" style="display: inline-block" data-sm-comment-icon="">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
<div class="question-body clearfix notranslate ">
<div class="textarea-container">
<textarea aria-labelledby="question-title-183746659" id="183746659" name="183746659" class="textarea" spellcheck="true" rows="3" cols="50" data-sm-textarea="" maxlength="20000"></textarea>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="question-row clearfix
">
<div data-question-type="open_ended_essay" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-184932224" data-qnumber="17" data-qdispnumber="17" data-question-id="184932224" class=" question-essay qn question essay">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-184932224" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 17<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Please share any additional comments you have below:</span>
<div id="new-commenting-icon_184932224" data-survey-id="412686829" data-question-id="184932224" data-language-code="en" style="display: inline-block" data-sm-comment-icon="">
<div class="question-comment active content hidden new-commenting"><span class="question-comment-icon smf-icon">w</span></div>
</div>
</h4>
<div class="question-body clearfix notranslate ">
<div class="textarea-container">
<textarea aria-labelledby="question-title-184932224" id="184932224" name="184932224" class="textarea" spellcheck="true" rows="3" cols="50" data-sm-textarea="" maxlength="20000"></textarea>
</div>
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</div>
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</form>Text Content
BREAST INSTITUTE NZ - REFERRER FEEDBACK SURVEY QUESTION TITLE * 1. WHAT PRACTICE(S) DO YOU WORK FROM AND WHAT IS YOUR POSITION WITHIN THIS PRACTICE? W QUESTION TITLE * 2. HOW SATISFIED ARE YOU WITH THE QUALITY OF SERVICES PROVIDED BY BREAST INSTITUTE NZ? W Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied QUESTION TITLE * 3. PLEASE RATE THE COMMUNICATION YOU'VE HAD WITH OUR TEAM, E.G. WHEN PHONING RECEPTION, SPEAKING WITH OUR CLINICAL STAFF, OR VIA EMAIL. W Excellent Good Average Poor Very poor QUESTION TITLE * 4. HOW RESPONSIVE WERE WE IN ADDRESSING ANY ISSUES OR CONCERNS RELATED TO YOUR REFERRALS? W Extremely responsive Responsive Moderately responsive Not very responsive Not responsive at all QUESTION TITLE * 5. DO YOU RECEIVE OUR REPORTS IN A TIMELY MANNER? W Always Usually Sometimes Rarely Never QUESTION TITLE * 6. DO YOU HAVE ANY ISSUES RECEIVING OR READING OUR REPORTS? W Always Usually Sometimes Rarely Never QUESTION TITLE * 7. WHAT IS YOUR PREFERRED METHOD OF SENDING REFERRALS TO US? W Electronically EDI/BPAC ManageMyHealth Portal Hand Written (we have referral pads available for referrers) Online pdf Referral (available to download from our website) QUESTION TITLE * 8. WHAT IS THE FEEDBACK LIKE FROM YOUR PATIENTS AFTER THEIR APPOINTMENT WITH US? W Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied QUESTION TITLE * 9. DO YOU KNOW THAT WE ACCEPT COMMUNITY FUNDED REFERRALS? W Yes No QUESTION TITLE * 10. DO YOU KNOW THAT OUR RADIOLOGIST SPEAKS TO YOUR PATIENT ON THE DAY OF THEIR APPOINTMENT TO GO OVER THEIR RESULTS? INCLUDING THEIR PERSONAL BREAST DENSITY READING IF MAMMOGRAPHY IS PERFORMED. W Yes No QUESTION TITLE * 11. DO YOU KNOW THAT WE CAN PERFORM SAME DAY BIOPSIES IF DEEMED NECESSARY BY OUR RADIOLOGIST AND PATIENT CONSENTS? W Yes No QUESTION TITLE * 12. DO YOU KNOW THAT WE WILL CONTACT YOUR PATIENT DIRECTLY WITH THEIR LAB RESULTS, AS WELL AS SET UP A CONSULTATION WITH OUR ONSITE BREAST SURGEON IF FOLLOW UP IS NECESSARY? W Yes No QUESTION TITLE * 13. DO YOU KNOW THAT WE CAN PERFORM CONTRAST ENHANCED MAMMOGRAPHY? (WE ARE THE ONLY CLINIC TO OFFER THIS PROCEDURE IN NZ) W Yes No QUESTION TITLE * 14. IF YOU DID NOT KNOW ABOUT THE ABOVE SERVICES WE PROVIDE, WOULD YOU BE MORE LIKELY TO REFER TO US NOW, KNOWING THIS? W Very likely Likely Neither likely nor unlikely Unlikely Very unlikely QUESTION TITLE * 15. WOULD YOU LIKE MORE INFORMATION ABOUT THE BREAST INSTITUTE NZ AND OUR SERVICES? WE CAN DROP OFF PAMPHLETS AND POSTERS TO YOUR PRACTICE AND/OR WE CAN ORGANISE FOR ONE OF OUR CLINICAL STAFF MEMBERS TO SPEAK AT YOUR NEXT STAFF MEETING OR PEER REVIEW STUDY DAY. W QUESTION TITLE * 16. IS THERE ANYTHING WE COULD BE DOING BETTER? THIS COULD SPECIFIC TO HOW WE INTERACT WITH YOUR PARTICULAR PRACTICE. W QUESTION TITLE * 17. PLEASE SHARE ANY ADDITIONAL COMMENTS YOU HAVE BELOW: W Submit Survey Powered by See how easy it is to create surveys and forms. Privacy & Cookie Notice Javascript is required for this site to function, please enable.