Diagnostic Imaging Central Intake Question Title * 1. Thinking about the requisitions you send, what % do you estimate wait 2 weeks or longer to be acknowledged as received by DI Central Intake? 0% 50% 100% Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 2. What % do you estimate wait 4 weeks or longer to be acknowledged? 0% 50% 100% Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 3. How much additional time does your practice have to invest to track and follow up on requisitions that have exceeded 14 days waiting on acknowledgement from central intake? 0 hours per week 1-2 hours per week 3-4 hours per week 5-6 hours per week 7+ hours per week Question Title * 4. How does your practice track requisitions? What has your experience been trying to follow up to confirm where a requisition is at? Question Title * 5. What impacts has central intake delays had on patient care? Choose all that apply to you practice Has not had an impact on patient care in my practice Delayed testing for patients Resulted in a delay in diagnosis Resulted in additional treatment than would have been required without the delay Resulted in a worse outcome for a patient Question Title * 6. Please describe (do not include any identifying patient information): Question Title * 7. Do you have any other concerns or suggestions when it comes to diagnostic imaging? Optional: Below we ask for our name and email. This is optional, and will only be used within Doctors Manitoba to follow up if more information would be helpful. Question Title * 8. Name Question Title * 9. Email Done