Patient experience survey

A short, respectful survey after a visit covering welcome, waiting and communication, with a route for complaints and kudos.

About 2 min to complete. patient feedback, clinic, satisfaction.

Questions in this template

1. Overall, how satisfied were you with your visit?
2. How long did you wait past your appointment time?
3. How much do you agree?
4. What should we do differently?
5. Is there anyone you would like to thank?
6. Would you like the practice manager to contact you?
7. Best email to reach you

Related templates

• Patient intake
• Appointment request
• Weekly wellness check-in
• Dental new patient form