Q01
メッセージ
すべてのテンプレートHealthcare & Clinical
Dental Patient Experience & Satisfaction Survey
Measures how patients experience each stage of a dental visit — booking, wait times, pain management, cost transparency, and trust in the dentist — and what drives their willingness to recommend the practice. Built for dental practices and group practices benchmarking patient experience, with an AI follow-up that uncovers the real story behind low or high recommendation scores, especially around anxiety and trust.
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12問・約7分
Q02
選択式必須
What was the main reason for your most recent dental visit?
- Routine checkup and cleaning
- Specific procedure (filling, crown, root canal, etc.)
- Dental emergency (pain, injury, broken tooth)
- Cosmetic treatment (whitening, veneers, etc.)
- Other
Q03
選択式必須
In the last 2 years, how many times have you visited a dentist?
- 3 or more times
- Twice
- Once
- Not at all
Q04
マトリクス必須
Thinking about your most recent visit, how would you rate each of the following?
6行 × 5列
- Wait time before being seen
- Friendliness of front-desk and clinical staff
- How clearly the dentist explained your treatment
- Management of pain or discomfort during treatment
- Cleanliness of the office
- ほか1件
列: Poor · Fair · Good · Very good · Excellent
Q05
オピニオンスケール必須
How likely are you to recommend this dental practice to a friend or family member?
スケール: 0 – 10
最小:Not at all likely最大:Extremely likely
Q06
ベスト・ワースト選択（MaxDiff）必須
When choosing a dental practice, which of these matter most to you and which matter least?
- Appointment availability that fits my schedule
- Clear, upfront pricing
- Friendly, approachable staff
- Modern equipment and technology
- Minimal wait times
- Insurance and payment plan options
- Clear explanations of treatment and next steps
- Gentle, low-pain procedures
各セットで最も良いもの・最も悪いものを選択最も良い:Matters most最も悪い:Matters least
Q07
選択式
In the last 2 years, has dental anxiety ever caused you to delay or skip a recommended appointment?
- Yes, more than once
- Yes, once
- No, never
- I don't experience dental anxiety
Q08
AIインタビュー
Probe the reasoning behind the respondent's recommendation score: ask them to describe the specific moment or interaction that most shaped that score, whether positive or negative. If they reported dental anxiety or a low rating on pain management or cost transparency, dig into what exactly happened, how staff responded, and what would have made them feel more at ease or trusting of the practice.
Q09
自由回答（長文）
Is there anything else about your recent dental visit — good or bad — you'd like the practice to know?
Q10
選択式
Which age range do you fall into?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+
- Prefer not to say
Q11
選択式
What best describes your dental insurance coverage?
- Employer-provided dental insurance
- Individually purchased dental insurance
- Public/government dental coverage
- No dental insurance
- Prefer not to say
Q12
メッセージ
Thank you for sharing your experience! Your feedback goes directly into a report the practice uses to improve patient comfort, communication, and care.
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
- Walks patients through every stage of the visit — booking, wait times, pain management, cost transparency, and trust — not just a single overall rating
- Includes a dedicated question on whether dental anxiety caused patients to delay or skip care, directly tied to an AI follow-up interview that probes the real reasoning behind high or low recommendation scores
- Pairs a MaxDiff exercise on what matters most when choosing a practice with an open-ended long-text question, so quantitative priorities and qualitative context are captured in one flow
- Automatically compiles responses into a report, so practices get analysis-ready findings without manually coding open-ended anxiety and trust comments
Jotform
Dental Patient Experience Survey Form TemplateA ready-to-field dental patient experience form built on Jotform's general form builder. It covers standard experience questions but is a static form rather than a research-tuned instrument with built-in benchmarking logic. Good for quick deployment, less suited to deeper diagnostic analysis of recommendation drivers.
優れている点
- Ready-to-use, no-code form that's easy to deploy quickly
- Backed by Jotform's broad form-building and customization ecosystem
- Likely supports common form fields (ratings, multiple choice) out of the box
物足りない点
- Static question set with no adaptive follow-up to probe why a patient gave a particular score
- No voice-based interview option for capturing patient sentiment
- No published methodology or per-response quality scoring
QuestionPro
Dental Care Survey TemplateA conventional dental care survey template from a general-purpose survey platform. It likely covers care quality and satisfaction basics but reads as a broad category template rather than one purpose-built around anxiety, trust, and recommendation drivers. Useful as a baseline, but shallow on the psychological 'why' behind scores.
優れている点
- Part of a large template library with enterprise survey features
- Supports standard analytics and dashboarding for aggregate reporting
- Likely offers customizable question types typical of QuestionPro's builder
物足りない点
- No adaptive AI interviewing to dig into specific low or high recommendation scores
- No dedicated focus on dental anxiety as a driver of care avoidance
- Fixed-form structure without transparent, reviewable AI prompt logic
SurveyMonkey
Patient Satisfaction Survey TemplateA generic post-visit patient satisfaction template, not specific to dental practices. It can be adapted for dental use but lacks any dentistry-specific content around anxiety, cost transparency, or trust in the dentist. Best viewed as a general healthcare satisfaction starting point rather than a dental-tailored instrument.
優れている点
- Backed by SurveyMonkey's established survey distribution and analytics tools
- Generic patient satisfaction framing that's easy to adapt across healthcare settings
- Likely includes standard satisfaction and NPS-style questions
物足りない点
- Not dental-specific — no questions on dental anxiety, pain management, or dentist trust
- Static question flow with no AI-driven follow-up on individual responses
- No voice interview option or automated per-response quality scoring
よくあるご質問
「Dental Patient Experience & Satisfaction 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12問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes to share feedback on your recent dental care. Your honest answers help the practice impr…」・「What was the main reason for your most recent dental visit?」・「In the last 2 years, how many times have you visited a dentist?」。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、12問を約7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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