Introducing User Segmentation — Deliver surveys and feedback forms with precise targeting using powerful User Segments. Learn more ➝

Get it For Free
Request a Demo

Book a Demo with Zonka Feedback


Get Started for Free

Enter primary contact's full name
Enter primary contact's email address
Choose a password (at least 6 characters, no spaces, case-sensitive)
  • Your account is being created in the
By proceeding, you agree to the Terms of Service and Privacy Policy.
Or, sign up with email

user-picsrating-star crowd-logo captera-logo Rated 4.8/5 stars

Post-Appointment Outpatient Feedback Form Template

How was patient's appointment with the doctor at your hospital or clinic? Get patient feedback post appointment using this Outpatient Feedback Form template.

  • Try 14 days for Free
  • Lightening fast setup

Take post-appointment outpatient feedback seamlessly via our feedback form.

Getting post-appointment is necessary for the hospitals. It allows them to have a clear picture of how the patient felt after getting an appointment. The feedback form has all the necessary questions such as if your privacy was protected during the appointment, did you get your prescription timely after the appointment, what did you like about the appointment process, what you disliked about the appointment process and more.

Share the feedback form with the patient just after they are done with their appointment. You can share the feedback form via email, in the kiosk or via SMSes.

To create a survey using the Post Discharge Inpatient Feedback Form Template, just sign up or sign in to Zonka Feedback. You’ll be able to choose this Survey Template when you begin creating your feedback form or survey.

List of Post-Appointment Outpatient Feedback Form

The following questions are included in this Post-Appointment Outpatient Feedback Form Template.

  • Rate the information provided to you prior to your appointment at the clinic.
  • How was the promptness and efficiency of your appointment?
  • What is your feedback about the information give to your immediately after your appointment?
  • What do you think about the timeliness of the letter and prescription received by the doctor after your appointment?
  • Did you feel that the staff respected your privacy and dignity during your visit and appointment today?
  • Was there anything that you particularly LIKED? (please also share here if you thought any staff member was particularly helpful)
  • Was there anything that you particularly DISLIKED?
  • Based on your appointment today, how likely are you to recommend us to your friends and family?

Sign Up on Zonka Feedback for free and implement a Post-Appointment Outpatient Feedback Form Template in your account to capture the data.

Create and send this Post-Appointment Outpatient Feedback Form Template

Get Started