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.
Scan this QR code to use this paper checklist on your smartphone or tablet or
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Title Page
Department
Conducted on
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Location
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:
SafetyCulture Staff
Patient Satisfaction Survey Template
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.
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions.
The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction.
You should independently determine whether the template is suitable for your circumstances.
