Patient Satisfaction Survey Template

Utilize this Patient Satisfaction Survey Template to gather feedback and assess the service quality experience through ratings provided by your patients.

Library
Healthcare
Patient Satisfaction Survey Template

Please Use The Following Scores To Rate Your Experience Strongly Agree â€“ 5, Agree â€“ 4, Uncertain â€“ 3, Disagree â€“ 2, Strongly Disagree - 1

Is this sample what you are looking for?
Sign up to use & customise this template, or create your own custom checklist:

Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

Easy inspection app for your digital checklists

Conduct inspections anytime, anywhere - even offline
Capture photos as proof of compliance or areas needing attention
Instantly generate and share detailed reports after the inspections
Assign & track follow-up tasks, view historical trends on a centralized dashboard

Patient Satisfaction Survey Template

Utilize this Patient Satisfaction Survey Template to gather feedback and assess the service quality experience through ratings provided by your patients.

1. Were the doctors careful to examine everything when treating and checking me?

2. I have received very good medical care

3. Doctors are not too serious and impersonal to patients

4. I am confident that I can receive the medical care I need without being set back financially

5. Doctors have explained the reason for the recommended medical tests

6. I have clear access to the medical specialists I need

7. I think my doctor's office has everything required to implement provide quality medical care

8. Where I go for medical care, I do not have to wait too long for emergency medication

9. My doctors treat me in a kind and polite manner

10. I have trust in the ability of the doctors who treat me

11. I can get medical care whenever I need it

12. Those who give me my medical care are not in too much of a rush when they treat me

13. I am charged reasonably for my medical care

14. Doctors do not ignore what I tell them

15. Doctors spend sufficient / plenty of time with me

16. It is easy to get an appointment for medical care

17. I am happy with the medical care I received