Patient Satisfaction Questionnaire Template
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Patient Satisfaction Questionnaire

Please complete this form to evaluate and understand patient experiences, needs, and preferences regarding the care and services received.

Patient Information

Patient ID

    Date of Visit

      Department/Service

        Physician/Nurse

          Quality of Care

          How would you rate the quality of care you received?

            Was the medical staff respectful and attentive to your needs?

            Were your medical issues explained in a way that was easy to understand?

            Facility & Comfort

            How would you rate the cleanliness and comfort of the facility?

              Was the waiting time reasonable?

              Were all safety protocols (e.g., hygiene, COVID-19 guidelines) followed?

              Communication & Follow-Up

              Did the staff provide you with clear follow-up instructions?

              How satisfied are you with the ease of booking appointments?

                How likely are you to recommend our services to others?

                How likely are you to recommend our services to others?

                  Please check the box below to proceed

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