Patient Satisfaction Survey Template
Gather valuable feedback on patient experience with a comprehensive satisfaction survey covering provider quality, facility, and care coordination.
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What is a Patient Satisfaction Survey?
A patient satisfaction survey collects feedback on patients' healthcare experiences, including provider quality, facility cleanliness, communication, wait times, and overall satisfaction. This feedback drives quality improvement, informs staff training, and helps practices identify service gaps.
Patient satisfaction metrics (Press Ganey, CMS surveys) increasingly impact healthcare reimbursement and hospital ratings. Practices use satisfaction surveys to track performance, benchmark against industry standards, and identify improvement opportunities.
Effective patient surveys are brief (5-10 questions), use rating scales for easy analysis, and include open-ended questions for detailed feedback. Survey frequency (after each visit, quarterly, annually) depends on the organization's quality improvement goals.
Key Features
Provider Rating Scale
1-5 or 1-10 scale for rating provider quality and bedside manner
Facility Assessment
Rating scale for cleanliness, comfort, and facility quality
Net Promoter Score (NPS)
"Would you recommend us to others?" scale measuring loyalty
Wait Time Feedback
Assessment of appointment punctuality and wait times
Communication Quality
Rating of provider explanation and patient engagement
Open-Ended Feedback
Text area for detailed comments and improvement suggestions
Why Use This Template?
Identify Improvement Areas
Feedback highlights specific areas for quality improvement
Track Performance
Regular surveys measure satisfaction trends and improvement progress
Improve Reimbursement
CMS and insurance programs reward high patient satisfaction scores
Enhance Reputation
Patient feedback helps identify strengths to highlight in marketing
What's Included in This Template
How would you rate your provider?
selectMeasures provider quality and patient satisfaction
How would you rate the facility?
selectAssesses cleanliness, comfort, and facility condition
How long did you wait?
selectMeasures appointment punctuality and wait time satisfaction
Did the provider explain things clearly?
selectAssesses communication quality and patient understanding
Would you recommend us to others?
selectNet Promoter Score measuring overall satisfaction and loyalty
What could we improve?
textareaCaptures specific feedback and improvement suggestions
Overall satisfaction
selectMeasures general satisfaction across all visit aspects
Perfect For
Hospital Quality Programs
Track patient satisfaction as part of CMS quality reporting
Clinic Improvement Initiatives
Identify and address patient experience gaps and opportunities
Provider Performance Evaluation
Include patient feedback in provider evaluations and compensation
Accreditation & Licensing
Demonstrate quality improvement through patient satisfaction metrics
Frequently Asked Questions
How often should I send satisfaction surveys?
Post-visit surveys (after each visit or quarterly) capture detailed feedback while the experience is fresh. Annual comprehensive surveys track longitudinal trends. High-volume practices use post-visit surveys; low-volume practices may do quarterly or annual surveys.
Should surveys be anonymous?
Most healthcare organizations use anonymous surveys to encourage honest feedback and protect patient privacy. Some send identified surveys to link feedback to specific providers/visits. Balance feedback quality with actionability - identified surveys allow targeted follow-up.
What is NPS and how do I use it?
Net Promoter Score: Ask "How likely to recommend (0-10)?" Promoters (9-10) = +1, Passives (7-8) = 0, Detractors (0-6) = -1. Calculate: (# promoters - # detractors) / total * 100. Target NPS 50+. Identify detractors for follow-up and improvement.
How do I respond to negative feedback?
Flag low scores for follow-up. Contact patient: "We're sorry you had a difficult experience. [Provider] would like to discuss what happened." Address concerns, offer apology if warranted. Track trends - repeated complaints about specific issues need systematic improvements.
Can I use this survey for CMS reporting?
CMS uses validated surveys (HCAHPS for hospitals). For clinics/offices, create your own or use AAPAC standards. Your survey doesn't replace CMS-required surveys but can supplement them. Focus on actionable metrics linked to quality improvement.
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