Centegra Mammography / Bone Density Survey Centegra Mammography or Bone Density Survey Thank you for trusting us with your care. It is important that we understand how we are doing from your point of view. To help us discover this information, please take a moment to complete this survey. The results will be used to reward and recognize, educate staff, and improve our service to you. Please select the location you are providing feedback on for our Mammography or Bone Density services:*Centegra Hospital-McHenryCentegra Hospital-WoodstockCentegra Health Center-HuntleyOverall safety and comfort during your visit*Very GoodGoodFairPoorVery Poorn/aComfort and Cleanliness of the Facility*Very GoodGoodFairPoorVery Poorn/aFriendliness/Courtesy of the staff who provided your test*Very GoodGoodFairPoorVery Poorn/aDegree to which your needs were met*Very GoodGoodFairPoorVery Poorn/aOverall rating of your visit*Very GoodGoodFairPoorVery Poorn/aI feel my questions/concerns were adequately addressed*Very GoodGoodFairPoorVery Poorn/aComments (please describe good or bad experience)Name First Last PhoneCell PhoneAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.