Free Patient Satisfaction Questionnaire Template
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
Questionnaire Templates @ Template.net
