Q01
メッセージ
すべてのテンプレートHealthcare & Clinical
Contactless Health Screening Experience Survey
Captures how people experience contactless health screening kiosks or apps—ease of use, trust in accuracy, and privacy comfort—for clinics, workplaces, and events. An AI follow-up interview digs into the specific moment trust broke down or friction occurred, beyond a simple satisfaction score.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全11問・約6分
Q02
選択式必須
Where did you most recently go through a contactless health screening?
- Workplace or office building
- Clinic or hospital
- Airport or transit hub
- Event, venue, or gym
- School or campus
- Other (Replace with your own context if this list doesn't fit)
Q03
オピニオンスケール必須
How easy was it to complete the screening (e.g., standing in front of a scanner, answering prompts on a kiosk)?
スケール: 1 – 7
最小:Very difficult最大:Very easy
Q04
オピニオンスケール必須
How much do you trust that the screening result was accurate?
スケール: 1 – 7
最小:Don't trust it at all最大:Trust it completely
Q05
マトリクス必須
Thinking about that same screening, how much do you agree with each statement?
5行 × 5列
- It was faster than a manual check-in
- I understood what was being measured or asked
- I felt my personal health data was handled respectfully
- Staff or signage made the process clear
- I would be comfortable going through it again
列: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q06
選択式
In the last time you used it, did you run into any of these issues?
- Long wait or queue
- Device didn't read correctly on the first try
- Confusing instructions
- Concerned about who sees my data
- Felt rushed or watched by staff
- Screening flagged me incorrectly
Q07
評価スケール必須
Overall, how satisfied were you with the contactless screening experience?
範囲: 1 – 5
最小:Very dissatisfied最大:Very satisfied
Q08
AIインタビュー
Reconstruct the respondent's most recent contactless screening moment in concrete detail: what device or app was used, what happened step by step, and whether the result felt accurate. If they reported low trust or an issue (long wait, misread, data concerns, incorrect flag), probe exactly what happened, how staff responded, and what would have restored their confidence. If everything went smoothly, ask what specifically made it feel trustworthy and fast.
Q09
選択式
What is your age range?
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q10
選択式
How do you describe your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q11
メッセージ
That's everything — thank you for sharing your experience! Your answers, along with the follow-up conversation, will help the teams running these screenings make the process faster, clearer, and more trustworthy.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes an AI follow-up interview that reconstructs the respondent's actual screening moment to find where trust broke down or friction occurred, not just a satisfaction number
- Combines an opinion-scale trust/ease pair with a matrix of agreement statements and a specific issues checklist, giving both breadth and depth on the same recent experience
- Uses transparent, auto-generated reporting so clinics, workplaces, and event organizers can see exactly what was asked and why
- Structured to work across contexts (clinics, workplaces, events) rather than locking into one vertical like airlines or a single symptom-check use case
QuestionPro
Contactless Health-Screening Survey Template for AirlinesThis is a fielding-ready static template but scoped specifically to airline travelers rather than clinics, workplaces, or events. It covers standard satisfaction and trust questions but has no mechanism to probe deeper on individual answers. Useful as a narrow vertical starting point, less useful for broader contactless screening research.
優れている点
- Purpose-built for the airline travel context
- Likely quick to deploy as-is for that niche
- Comes from an established survey platform with broad template library
物足りない点
- Static question set with no adaptive follow-up when a respondent flags low trust or friction
- No voice interview or guided screen-share option to observe the actual screening moment
- No transparent, publishable prompt methodology since there are no AI-driven questions at all
Jotform
COVID-19 Daily Health Screening Form TemplateThis is a daily symptom-check intake form rather than an experience/satisfaction survey about contactless kiosks or apps — it's built for operational screening logs, not for understanding trust or friction in the screening experience itself. It's fielding-ready but serves a different purpose than an experience research template.
優れている点
- Simple, fast form intended for daily operational use
- Familiar Jotform builder for easy customization of fields
- Free-tier accessible template
物足りない点
- Designed for symptom logging, not for capturing trust, ease-of-use, or privacy comfort with the screening technology itself
- No adaptive follow-up interview to dig into a specific bad experience
- No automated quality scoring or auto-generated experience report
よくあるご質問
「Contactless Health Screening Experience Survey」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が11問含まれており、最初の設問は次のとおりです：「Hi! We're looking at how people experience contactless health screening (temperature/symptom kiosks, apps, or scanners)…」・「Where did you most recently go through a contactless health screening?」・「How easy was it to complete the screening (e.g., standing in front of a scanner, answering prompts on a kiosk)?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、11問を約6分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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