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Patient Satisfaction Survey

Patient Satisfaction Questionnaire

Doctors are good about explaining the reason for medical tests

I think my doctor's office has everything needed to provide complete medical care

The medical care I have been receiving is just about perfect

Doctors do not make me wonder if their diagnosis is correct

I feel confident that I can get the medical care I need without being set back financially

When I go for medical care, they are careful to check everything when treating and examining me

I do not have to pay more than I can afford for my medical care

I have easy access to the medical specialists I need

Where I get medical care, people do not have to wait too long for emergency treatment

Doctors are not too businesslike and impersonal toward me

My doctors treat me in a very friendly and courteous manner

Those who provide my medical care are not too much in a hurry when they treat me

Doctors do not ignore what I tell them

I trust the ability of the doctors who treat me

Doctors usually spend plenty of time with me

It's easy to get an appointment for medical care right away

I am satisfied with the medical care I receive

I am able to get medical care whenever I need it

Patient's overall comment:

Patient Satisfaction Survey Template Checklist

Created by: SafetyCulture Staff | Industry: Health Services | Downloads: 89

This patient satisfaction survey template can help medical professionals quickly determine the level of patient satisfaction on the medical care provided. Conduct this survey via kiosks or mobile devices administered by staff.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

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Patient Satisfaction Survey

Patient Satisfaction Questionnaire

Doctors are good about explaining the reason for medical tests

I think my doctor's office has everything needed to provide complete medical care

The medical care I have been receiving is just about perfect

Doctors do not make me wonder if their diagnosis is correct

I feel confident that I can get the medical care I need without being set back financially

When I go for medical care, they are careful to check everything when treating and examining me

I do not have to pay more than I can afford for my medical care

I have easy access to the medical specialists I need

Where I get medical care, people do not have to wait too long for emergency treatment

Doctors are not too businesslike and impersonal toward me

My doctors treat me in a very friendly and courteous manner

Those who provide my medical care are not too much in a hurry when they treat me

Doctors do not ignore what I tell them

I trust the ability of the doctors who treat me

Doctors usually spend plenty of time with me

It's easy to get an appointment for medical care right away

I am satisfied with the medical care I receive

I am able to get medical care whenever I need it

Patient's overall comment: