Patient Satisfaction Survey Template

Customize template

Patient feedback is priceless for improving healthcare services, this is why our ready-made template helps you collect patient impressions about the medical care they received, facility hygiene and doctor-patient communication. Add other specific questions to the patient questionnaire if you want to. Personalizing our forms requires no coding skills, only a drag and drop effort. Make sure you add your clinic logo, an adequate layout and set multiple email recipients if needed.

Publish template

This patient satisfaction survey fits perfectly on any device, so patients can submit their responses right after appointments from their smartphones or tablets. Send the questionnaire link anywhere you want with a simple copy-paste, embed it on a website source code or use the lightbox display if you prefer. Share it on a social media page to find your patients where they are and make it easier for them to engage.

Collect & manage data

Our form builder is here to help you create reports that will land you the best insights and have a better picture of what needs further improvements within your healthcare facility. Data collection via our web forms is completely secure and you can add HIPAA compliance to your patient feedback form with just a few clicks. We also offer powerful analytics, downloadable reports to share with your team and also the option to integrate with multiple third-party applications.

Optimize processes

Delivering excellent healthcare relies particularly on patient feedback. The patient satisfaction questionnaire by 123 Form Builder brings you the most relevant information at the right time, simplifying medical administrative tasks at a great length. All you need to do is create an account and start exploring patient opinions.