Healthcare & Clinical

Patient Experience Survey: Access, Communication & Care Quality

Measures patient satisfaction across appointment access, provider communication, follow-up timeliness, and digital touchpoints for healthcare organizations seeking actionable improvement insights and NPS benchmarking.

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Patient Experience Survey: Access, Communication & Care Quality

Welcome, and thank you for taking the time to share your experience. This brief survey asks about your most recent healthcare visit within the past 6 months and should take about 11 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions. All responses are confidential and will be reported only in aggregate to help us improve the care we provide.

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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20問・約10分

メッセージ

Welcome, and thank you for taking the time to share your experience. This brief survey asks about your most recent healthcare visit within the past 6 months and should take about 11 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions. All responses are confidential and will be reported only in aggregate to help us improve the care we provide.

Q01

プルダウン

When was your most recent visit or interaction with us?

Within the last 7 days
2–4 weeks ago
1–3 months ago
3–6 months ago

Q02

選択式

What type of care did you receive most recently?

Primary care
Specialist visit
Urgent care
Telehealth/video visit
Message-only consult
Lab or imaging
Pharmacy/medication delivery
Other

Q03

選択式

How did you schedule or start that visit?

Website
Mobile app
Phone call
Walk-in
Referral link or email
Third-party marketplace
Other

Q04

オピニオンスケール

Overall, how easy was it to get the care you needed?

スケール: 1 – 7

最小:Very difficult最大:Very easy

Q05

プルダウン

Approximately how long did you wait past your scheduled appointment time?

Seen on time or early
1–10 minutes
11–20 minutes
21–30 minutes
31–45 minutes
More than 45 minutes
Not applicable (e.g., telehealth, walk-in)

Yes, within 24 hours
Yes, within 2–3 days
Yes, but later than 3 days
No follow-up was needed
No, I expected follow-up but did not receive it

Q11

評価スケール

Overall, how would you rate your experience with the clinician you saw?

範囲: 1 – 5

最小:Poor最大:Excellent

Q12

オピニオンスケール

My main health concern was addressed or resolved during this visit.

スケール: 1 – 7

最小:Strongly disagree最大:Strongly agree

Q13

オピニオンスケール

How likely are you to recommend our care to a friend or family member?

スケール: 0 – 10

最小:Not at all likely最大:Extremely likely

Q14

選択式

Which of the following digital features, if any, did you use for this visit? Select all that apply.

Online booking
Secure messaging
View lab results
Prescription refill
Payment/checkout
Order tracking for meds/devices
None of the above

Q15

オピニオンスケール

How easy was the website or app to use for your needs?

スケール: 1 – 5

最小:Very difficult最大:Very easy

Q16

自由回答（長文）

Based on your experience, what is one thing we could improve for patients like you?

Q17

AIインタビュー

We'd like to learn a bit more about your visit. An AI moderator will ask you a couple of brief follow-up questions based on your responses.

Q18

選択式

What is your age group?

18–24
25–34
35–44
45–54
55–64
65+
Prefer not to say

Q19

選択式

What is your gender?

Woman
Man
Non-binary
Prefer not to say

Q20

プルダウン

In which country do you currently reside?

United States
United Kingdom
Canada
Australia
European Union
Other country
Prefer not to say

メッセージ

Thank you for your feedback—your responses will help us improve care for patients like you.

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 a dedicated AI follow-up interview segment that lets patients elaborate on their visit in their own words, beyond fixed-choice questions
Covers the full experience arc in one instrument: appointment access and wait time, provider communication (listening, clarity, respect, involvement), follow-up timeliness, and digital touchpoint usage
Pairs a clinician rating and an explicit recommend-likelihood question with an open-text improvement prompt, giving both quantifiable NPS-style benchmarking and qualitative signal
Uses transparent, reviewable question and interview prompts plus automated scoring, so healthcare teams can audit exactly what was asked and how responses were evaluated

SurveySparrow

Free Patient Satisfaction Survey Template | For Healthcare Industry

A ready-to-use static patient satisfaction template covering standard experience dimensions like care quality and staff interaction. It's built for quick deployment across chat-style or classic survey formats but relies on fixed questions rather than adaptive probing. Good for teams wanting a fast baseline NPS-type survey without deeper qualitative follow-up.

優れている点

Free, ready-to-field template aimed specifically at healthcare patient satisfaction
Supports SurveySparrow's conversational-style survey format for better completion rates
Likely includes standard satisfaction and NPS-style questions out of the box

物足りない点

No adaptive AI follow-up interview to probe individual patient answers in real time
No indication of automated per-response quality scoring or transparent prompt methodology
Static question set means all patients see the same questions regardless of their answers

QuestionPro

Health Insurance Satisfaction Survey Template

This template is focused on health insurance satisfaction rather than direct patient care experience (access, provider communication, follow-up), so it targets a narrower and somewhat different use case than a clinical patient experience survey. It's a standard fielding-ready form template within QuestionPro's broader survey platform. Useful if the goal is plan/insurer feedback rather than care-quality benchmarking.

優れている点

Ready-to-use template within an established enterprise survey platform
Likely includes robust reporting and cross-tab analysis tools typical of QuestionPro
Can be customized within a mature survey-logic builder

物足りない点

Template topic (insurance) is not a direct match for care-quality/provider-communication measurement
No adaptive AI-driven follow-up interviews or voice AI interview option
No transparent, auditable prompt-level methodology for how responses are scored

SurveyMonkey

Patient Satisfaction Survey Template

A post-visit patient satisfaction template covering common experience touchpoints, positioned as a straightforward fielding-ready survey. It's built on SurveyMonkey's traditional question-and-logic survey engine rather than any conversational or AI-driven interview format. Solid for basic post-visit pulse checks but limited for deeper qualitative insight.

優れている点

Ready-to-field template from a well-known, widely trusted survey platform
Likely supports skip logic and benchmarking against SurveyMonkey's question bank
Simple setup for post-visit satisfaction pulse surveys

物足りない点

No adaptive AI or voice AI interview component for deeper follow-up on patient answers
No automated per-response quality scoring described
Fixed-form structure only, without guided screen-share tasks or conversational probing

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