Text your way to Real-Time Feedback – Introducing WhatsApp Surveys! Learn more ➝

Outpatient Satisfaction and OPD Feedback Form Template

Capture real, actionable insights from patients right after their visit with our Outpatient Satisfaction and OPD Feedback Survey Template—because every detail counts in delivering outstanding care.

  • Try 14 days for Free
  • Lightening fast setup
Gain a clear view of patient satisfaction after each visit to your healthcare center. Our OPD feedback form helps you understand patient perceptions of care quality, treatment, and waiting times, making it easy to identify areas for improvement. Use these insights to continuously enhance the outpatient experience and elevate your healthcare services.

OPD Feedback Form Template Questions

  1. 1. Please rate your overall satisfaction with your outpatient experience

This question captures the patient's entire OPD experience at a glance. It offers a quick measure of overall satisfaction, helping you gauge how well your facility meets patient expectations from start to finish.

  1. 2. How likely are you to recommend our clinic/hospital to your family or friends?

  • 0 (Not at all likely)

  • 10 (Extremely likely)

    • This NPS survey question assesses patient loyalty and trust, indicating how likely they are to advocate for your facility. High scores here reflect strong patient confidence in your care, while lower scores highlight areas to strengthen.
  1. 3. Please rate the following aspects of your outpatient experience

Waiting Time

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

Staff Friendliness

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

Cleanliness and Hygiene

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

Clarity of Instructions

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

Quality of Care

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

This likert Scale question targets crucial parts of the patient experience like waiting time, staff friendliness, cleanliness, clarity of instructions, and care quality, highlighting strengths and improvement areas. With this patient satisfaction survey, you can make focused changes that create a more seamless, satisfying visit for patients.

  1. 4. How would you rate the experience with the doctor who attended to you?

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

This question focuses on the patient’s interaction with their doctor, a key component of trust and comfort in care. This patient satisfaction survey template reveals insights into the doctor’s overall experience to address patient needs.

  1. 5. Was the appointment booking process convenient and efficient?

  • Yes
  • No

This question evaluates the accessibility and ease of the booking process, giving you feedback on an often-overlooked touchpoint. Enhancing convenience here can improve the patient experience before they even enter your facility through patient satisfaction survey.

  1. 6. How would you rate the ease of finding information about our clinic/hospital (e.g., location, services)?

  • Very Poor

  • Poor

  • Average

  • Good

  • Excellent

Assessing the ease of access to essential information helps you understand if patients can easily navigate your services like medical treatment provided. Clear, accurate information reduces stress, improves patient confidence, and supports better patient flow.

  1. 7. Did you receive timely reminders or notifications regarding your appointment?

  • Yes
  • No

Timely communication shows patients that their time is valued. With this question, you can measures the efficiency of your reminder system, helping reduce missed appointments and enhancing patient satisfaction through proactive service.

  1. 8. Were the facilities and amenities at the clinic/hospital adequate and comfortable?

  • Yes
  • No

This question captures patient impressions of the clinic’s physical environment. It highlights how welcoming, clean, and comfortable your facility feels, directly impacting the patient’s overall comfort and perception of care.

  1. 9. Did the healthcare provider explain your diagnosis and treatment plan clearly?

  • Yes
  • No

Patients value clarity, especially regarding their health through medical professionals. This question ensures providers are effectively communicating treatment plans, which improves understanding, adherence, and patient trust in your facility’s care.

  1. 10. Were all your questions and concerns addressed during your visit?

  • Yes
  • No

Knowing that all concerns are addressed fosters trust and satisfaction. This question confirms if patients feel truly heard, revealing opportunities to improve communication and personalized care.

  1. 11. Please provide any additional comments or suggestions for improvements

Open-ended feedback offers valuable insights into patient needs that standard questions may not capture. Patients can share specific suggestions, providing a roadmap for actionable improvements in patient care.

  1. 12. Would you like to be contacted for further feedback or follow-up?

  • Yes
  • No

This question determines a patient’s willingness for follow-up, enabling your team to gather patient feedback and show a commitment to continuous improvement in patient care.

  1. 13. Personal Information

  • Full Name
  • Contact Number
  • Email Address
  • Patient ID

Collecting essential details enables you to maintain accurate records and personalize follow-up. With clear communication channels, you can better support patients, address concerns, and foster loyalty.

Each question in this feedback form is designed to provide a comprehensive understanding of the patient’s outpatient experience. From overall satisfaction and ease of booking to doctor interactions and facility comfort, medical staff or medical practice, these insights empower your clinic to make targeted improvements. By understanding specific areas like communication, convenience, and environment, this feedback helps your healthcare team enhance patient care, build trust, and ultimately create a more satisfying experience for every patient.

Customized Questions for Deeper Patient Insights

To tailor the feedback process to your clinic’s specific needs, consider adding customized questions to gain deeper insights into patient experiences. Below are some sample questions designed to capture valuable feedback on various aspects of the outpatient journey, from initial communication to post-visit care.

Before the Visit

  1. How comfortable and informed did you feel about the procedure or treatment before your appointment?

  • Scale: 1-10

  • Purpose: Understand if patients feel prepared and informed before their visit, highlighting any gaps in pre-visit communication.

During the Visit

  1. Did you feel that the healthcare provider spent sufficient time with you to address your concerns?

  • Response Options: Yes, No, Somewhat

  • Purpose: Measures the provider’s attentiveness and time commitment, essential for a positive, patient-centered experience.

  1. How would you rate the efficiency of our appointment process?

  • Response Options: Very Inefficient, Inefficient, Neutral, Efficient, Very Efficient

  • Purpose: Identifies bottlenecks in the appointment process to improve patient flow and satisfaction with medical practices with scheduling.

  1. How would you rate our communication regarding any delays or changes to your appointment time?

  • Response Options: Very Poor, Poor, Average, Good, Excellent

  • Purpose: Evaluates the clinic’s communication about delays or schedule changes, crucial for managing patient expectations.

After the Visit

  1. How satisfied were you with the follow-up care and information provided after your visit?

  • Response Options: Very Unsatisfied, Unsatisfied, Neutral, Satisfied, Very Satisfied

  • Purpose: Assesses the effectiveness of post-visit communication and follow-up care, ensuring patients feel supported after their appointment.

Open-Ended Feedback

  1. What aspect of your experience would you most like to see improved?

  • Response Options: Open-ended

  • Purpose: Allows patients to suggest specific improvements, offering actionable insights that may not be covered in other questions in the patient feedback form.

Each customized question is designed to capture specific insights into key areas of the outpatient experience, from pre-visit communication to post-visit care. This targeted feedback helps the clinic make precise improvements that enhance patient satisfaction.

How to use the Template

Unlock valuable insights into your patients’ experiences with our Outpatient Satisfaction and OPD Feedback Form Template. This step-by-step guide will walk you through setting up, customizing, and utilizing the template to capture comprehensive honest feedback from booking convenience to quality of care, empowering your team to make impactful, data-driven improvements and elevate patient's satisfaction at every touchpoint.

  • Sign Up for Zonka Feedback

    Begin by signing up for a free trial on Zonka Feedback. Once logged in, access the survey template library and find the Outpatient Satisfaction and OPD Feedback Form Template to get started.

  • Customize the Template:

    • Branding: Personalize the survey by adding your hospital or clinic’s logo, colors, and other brand elements for a professional and consistent look.

    • Tailor Questions: Edit questions to address specific aspects of patient satisfaction, such as waiting time, treatment quality, staff friendliness, and overall experience. Add additional questions if necessary to gather patient feedback relevant to your facility.

    • Set Up Survey Logic: Use conditional logic to tailor the patient feedback form based on responses. For example, if a patient rates their experience poorly, the survey can direct them to a follow-up question asking for more details.

    • Choose Language: Ensure accessibility by selecting the language that best suits your patient demographic, or enable multiple languages to cater to a broader audience.

  • Preview Your Survey:

    Before sharing the survey, preview it to ensure all questions are relevant, the branding is accurate, and the survey flow feels intuitive. Make any necessary adjustments to enhance the patient experience.

  • Select Distribution Channels:

    With Zonka Feedback, distribute your outpatient feedback form via the following channels:

    • In-Clinic Kiosk or Tablets: Set up tablets or kiosks in the outpatient department (OPD) for immediate, in-the-moment feedback right after patients complete their visit.

    • QR Codes: Place QR codes in the clinic or waiting areas for patients to scan and fill out the survey on their phones.

    • Email: Send the patient satisfaction survey to patients post-appointment to gather feedback on their visit.

    • SMS: SMS is effective for quick responses, especially for patients who may not check emails frequently.

  • Collect Responses in Real-Time:

    Zonka Feedback allows you to track responses as they come in, giving you timely insights into patient experiences. This real-time collection is vital for promptly addressing any issues reported.

  • Analyze and Act on Feedback:

    Leverage Zonka Feedback’s analytics tools to view trends, analyze patient sentiment, and measure key satisfaction metrics. Generate reports to understand what’s working well and where improvements are needed. Additionally, set up alerts for negative patient feedback to take immediate action.

Where to Use the Template in Your Healthcare Facility

Make every patient interaction count by gathering insights exactly when it matters most. Use the Outpatient Satisfaction and OPD Feedback Template at key touch points throughout your facility to encourage quick, honest patient feedback. This way, you’ll capture the insights you need to elevate patient care and satisfaction continuously.

  • At the Reception or Waiting Area Set up tablets or kiosks in the reception area so patients can quickly share their feedback before they leave, ideal for capturing their immediate thoughts.

  • Post-Visit Emails Send the survey directly to patients’ inboxes after their visit. This gives them time to reflect and share detailed insights on their experience.

  • Patient Portal or Mobile App Make it easy for patients to give feedback by embedding the survey in your patient portal or mobile app. This lets them respond anytime, right from their device.

  • QR Codes on Appointment Cards or Discharge Forms Conduct patient satisfaction surveys via adding QR codes to discharge papers or appointment cards so patients can scan and complete the survey on their phone—quick and convenient!

  • Follow-Up SMS Send a follow-up SMS with a survey link after their visit. It’s a simple way for patients to respond on the go, boosting your response rate.

Optimal Timing for Using the Outpatient Feedback Template

Gathering feedback at key moments is crucial for impactful insights. Use the Outpatient Satisfaction and OPD Feedback form Template at specific points in the patient journey to understand needs, improve care, and build trust effectively.

  • Immediately Post-Visit

    Capture patient feedback right after the patient’s appointment while their experience is fresh. You can distribute the survey via kiosks, tablets in the clinic, or send an SMS link immediately after checkout.

  • During Follow-Up Calls or Appointments

    If your clinic conducts follow-up calls or check-ins, this is an ideal time to gather additional insights on the patient’s satisfaction and their experience post-visit. The survey can be integrated into these follow-ups to gather feedback on continuity of care.

  • After Specific Procedures or Treatments

    For specialized procedures or treatments, sending a feedback form after the patient has had time to experience the results can yield more detailed insights into satisfaction and outcomes.

  • Periodically for Regular Outpatients

    For patients who visit regularly, consider sending the feedback form survey periodically to monitor satisfaction over time and address any ongoing concerns or changes in experience.

  • Upon Completion of a Care Plan

    For patients finishing a treatment plan, capturing patient feedback on their overall journey with your clinic provides valuable insights into both immediate and long-term satisfaction.

Why Choose Zonka Feedback for Outpatient Feedback?

Outpatient care thrives on details, and Zonka Feedback’s patient satisfaction survey template captures them all. Our tool empowers you with real-time, actionable insights helping you enhance care quality, streamline patient flow, and build lasting trust. See how Zonka Feedback turns responses into a better patient experience at every step.

  • Streamline Patient Flow with Zonka Feedback’s Real-Time Insights
    Zonka Feedback’s patient satisfaction survey template helps pinpoint exact wait time issues by capturing patient feedback at each stage, enabling you to take quick, effective actions to reduce delays.

  • Boost Staff-Patient Rapport Using Feedback Data
    With Zonka Feedback, easily track and address patient perceptions of staff interactions, giving you actionable data to guide focused training or recognize excellent service.

  • Enhance Care Quality and Clarity
    Zonka Feedback’s targeted questions reveal patient understanding of their treatment, allowing you to identify areas for improved communication and refine care instructions.

  • Maintain High Standards of Cleanliness and Safety
    Patient feedback gathered through Zonka Feedback enables ongoing assessment of cleanliness and safety, ensuring your facility consistently meets patient expectations and health standards.

  • Track and Optimize Satisfaction Trends Over Time
    Zonka Feedback’s analytics let you measure patient satisfaction trends, empowering you to prioritize improvements and allocate resources to areas with the most patient impact.

Frequently Asked Questions

  • Can I customize the patient satisfaction questionnaire to address specific needs in my clinic?

    Yes, you can easily add, modify, or rearrange questions to focus on areas like communication, follow-up care, or specific aspects of patient experience unique to your facility.

  • What are the best ways to distribute the patient satisfaction survey template?

    The form can be shared via email, SMS, patient portals, or through QR codes in the clinic, ensuring you gather feedback at convenient touchpoints for your patients.

  • How can I act on negative feedback quickly using Zonka Feedback?

    Zonka Feedback offers real-time notifications for specific responses, allowing you to set up alerts for negative feedback. This helps your team respond quickly and address concerns on the spot.

  • Does Zonka Feedback provide reporting options to help present findings to my team?

    Absolutely. Zonka Feedback offers detailed, customizable reports, including trend analysis and satisfaction scores, which can be easily shared with your team for review and action planning through patient satisfaction surveys.

  • How secure is patient information collected through the feedback template?

    Zonka Feedback complies with healthcare data security standards, ensuring that all patient data collected remains secure and confidential through the feedback form.

Create and send this Outpatient Feedback Form with Zonka Feedback

Get Started