Patient satisfaction survey template
Learn how patients experience your practice, from booking and waiting times to how clearly staff explained things, without asking about their health.
What’s in this template
- How was your visit? — Eight quick questions. About three minutes. We won’t ask about your health.Welcome
- 1When was your visit? (optional)Date
- 2How easy was it to get an appointment? (optional)Scale
- 3How long did you wait past your appointment time? (optional)Single choice
- 4How courteous were our staff? (optional)Scale
- 5How clearly were things explained to you? (optional)Scale
- 6How well did we listen to you? (optional)Scale
- 7Overall, how would you rate your visit? (optional)Rating
- 8What could we do better? (optional)Long text
- Thank you. Your answers help our whole team make every visit a little better.Ending
Who it’s for
- Clinics and medical practicesCheck the parts of a visit patients notice most: booking, waiting and how they were treated.
- Dentists, physical therapists and counselorsAsk for feedback after appointments without collecting any health information.
- Practice managersTrack waiting times and courtesy over time and share the results with your team.
Make it yours
- Use the templateIt becomes a draft in your workspace, named after the template, with its welcome screen and background. Nothing is published yet.
- Edit any questionReword it, change the answer type, add or remove screens, pick another background. The preview updates as you type.
- Publish and share the linkOne link, one question per screen, on any device. Answers land in your Responses tab.
Questions people ask
Does it ask about medical conditions?
No. The survey is about the visit itself: booking, waiting, courtesy and communication. It isn’t meant for clinical or personal health information, so don’t add questions that ask for it.
Can I change the questions?
Yes. Using the template creates a draft you can change completely: name your clinic or team in the questions, change the waiting-time ranges, or delete what you don’t need.
Is it anonymous?
The template doesn’t ask for a name or contact details, so answers aren’t tied to a patient unless they add one in the last question.
How do patients fill it in?
Share the form’s link by text message or email after the visit. It shows one question per screen and works on phones.
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Make the patient satisfaction survey yours.
Free · 8 questions · about 3 minutes. Sign in with your email and the draft is waiting.