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Patient Satisfaction Survey Template

Gather important patient insights with our effective Patient Satisfaction Survey Template. Capture feedback at different touchpoints to improve the quality of care & treatment and deliver healthcare services that yield high-level Patient satisfaction. 

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Understanding Patient Satisfaction Survey Template

Our Healthcare Patient Satisfaction Survey Template helps you create patient surveys quickly to capture healthcare data. Patient feedback through this survey template helps you identify and fill the gaps between patient expectations and the quality of the healthcare services you are providing.

There are different touchpoints throughout the patient interaction journey like Post-Appointment, Post-Discharge, Pharmacy, and so on, where you need to gauge how your healthcare facility, treatment, and care are perceived by patients. 

1. Post Appointment Survey

You can connect your patient feedback tool to your internal systems and send automated Post Appointment Patient Surveys through Emails and SMSs to get patient feedback in terms of appointment time, staff, doctor, the level of treatment, availability of medicines at the pharmacy, etc., right after their appointment.

2. Inpatient & Post Discharge Survey

During the patient’s stay, you can use this patient survey template to capture feedback in terms of hospital means, cleanliness, availability of staff, regularity and efficiency of checkups, etc. A Post Discharge Patient Feedback Form can effortlessly measure the core satisfaction levels of patients during their stay at the hospital at a transactional level. This survey can be filled by the patient or by their relative or spouse as well. This further helps you to improve the quality of your healthcare services and keeps yourself abreast of your patients' needs and expectations.

3. On-Premises Patient Feedback Survey

Besides care & treatment, patients perceive healthcare based on the quality of the pharmacy, visitors’ lounge, washrooms, etc. in the facility. Using our healthcare patient satisfaction survey template, you can capture feedback on different healthcare aspects like these and even collect more information you may need.

Based on what kind of patient feedback you’re looking to collect, you can add, remove or edit questions in this healthcare patient satisfaction survey template. 

Purpose of Patient Feedback Survey Template

Patient Feedback Survey Templates serve as a valuable tool for the healthcare providers to gather feedback and gain crucial insights into the patient experience. These surveys go beyond just a mere formality and act as a bridge for effective patient-provider communication and an avenue for continuous improvement by monitoring the overall satisfaction level of patients. 

By understanding the patient experience, healthcare facilities can identify the areas of improvement and tailor their services to meet the evolving needs of the patients. 

Components of Effective Patient Feedback Form Template

A well-crafted patient survey comprises of several components to provide comprehensive insights into the patient experience. Some crucial ones include:

1. Overall Experience Rating

Utilizing a scale for overall satisfaction allows patients to express their sentiments more candidly on the medical facility offered. Additional questions can delve into the specific aspects of patient experience, providing more nuanced understanding of the customer satisfaction. 

2. Communication and Interactions

Another aspect is that the template assesses the effectiveness of the communication between the patients and healthcare providers. It inquired about the clarity of medical information provided, ensuring that the patients feel informed and supported throughout their healthcare journey. 

3. Facility and Environment

By evaluating the cleanliness, comfort, and efficiency of the medical facility, you can address the aspects that contribute to the overall patient experience. 

4. Staff Competence and Courtesy

Patient satisfaction is tied to the competence of the healthcare staff and competence of the medical practices. The survey template with the right questions can provide the patients with the opportunity to rate and comment on specific interactions, fostering accountability, and recognition for exemplary service. 

5. Analyzing Survey Data

After gather feedback, one must analyze it appropriately to identify trends in the survey responses. Implementing and making feedback-driven changes is important for improving the patient experience and addressing common concerns raised by the patients. 

How to Use Healthcare Patient Satisfaction Survey Template?

You can use our Patient Feedback Form template in different ways:

Kiosks and Tablet – Automatically reloaded patient feedback surveys can be added to kiosks and tablet devices at important touchpoints like washrooms, pharmacy stores, reception, visitors’ lounges, etc., to capture instant patient feedback.

Email and SMS – Post-appointment or treatment feedback can be collected using automatic surveys triggered after appointments or patient discharge via email and sms. 

Website or App – You can collect post-appointment or appointment-booking experience feedback on your website using website feedback surveys. If you have your own app for online consultations and appointments, you can use in-app feedback surveys.

In order to run an impactful survey, it is essential to keep the surveys concise, survey questions relevant, updating the survey with evolving patient needs, and putting emphasis on the importance of the patient feedback in the continuous improvement process. 

You can use our healthcare patient satisfaction survey template to create engaging Patient Satisfaction Surveys. The template can be used for hospitals, clinics, or medical centers.

Just sign up or sign in to Zonka Feedback and begin creating your customized patient feedback surveys.

Questions in Patient Satisfaction Survey Template

  1. 1. Please rate your satisfaction with the care provided during your visit
    • 1
    • 2
    • 3
    • 4
    • 5
  2. 2. How well did the healthcare provider communicate with you?
    • Very Poor
    • Poor
    • Average
    • Good
    • Excellent
  3. 3. Please rate your satisfaction with the following aspects: Wait Time, Staff Friendliness, Cleanliness, & Clarity of Communication
    • Very Poor
    • Poor
    • Average
    • Good
    • Excellent
  4. 4. Are you satisfied with the follow-up care after your visit?
    • Yes
    • No
  5. 5. To what extent do you agree or disagree with the following statement? It was easy for me to schedule the appointment
    • Strongly Disagree
    • Disagree
    • Somewhat Disagree
    • Neutral
    • Somewhat Agree
    • Agree
  6. 6. Is there anything we can do to improve your satisfaction as a patient?

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