모든 템플릿

Post-Visit Patient Support & Education Experience Survey

Measures patient perceptions of post-visit support access, health education clarity, and care coordination quality. Designed for healthcare organizations seeking to identify gaps in patient communication and follow-up processes.

샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 22개 · 약 10분
Q01
메시지

Welcome, and thank you for participating. This brief survey (approximately 10 minutes) asks about your most recent healthcare visit. Your participation is 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 improve patient care.

Q02
객관식

When was your most recent healthcare visit?

  • Within the last 30 days
  • 1–3 months ago
  • 3–6 months ago
  • 6–12 months ago
  • More than 12 months ago
  • I have not had a visit in the past 12 months
Q03
의견 척도

How easy was it to reach your care team when you needed help?

척도: 17
최소:Very difficult최대:Very easy
Q04
의견 척도

The explanations I received about my condition and treatment were clear and easy to understand.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q05
의견 척도

The different providers involved in my care seemed to share information effectively with each other.

척도: 17
최소:Strongly disagree최대:Strongly agree
Q06
의견 척도

How confident are you in managing your health based on what you learned during your visit?

척도: 17
최소:Not at all confident최대:Extremely confident
Q07
AI 인터뷰

We'd like to understand your experience in more detail. An AI moderator will ask you a couple of brief follow-up questions about the support and education you received.

Q08
드롭다운

What is your age?

  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65–74
  • 75+
  • Prefer not to say
Q09
메시지

Thank you for completing this survey. Your feedback is valuable and will be used to improve patient support, education, and care coordination.

Q10
객관식

What type of care setting did you visit most recently?

  • Primary care / family medicine
  • Specialist clinic
  • Hospital outpatient clinic
  • Emergency or urgent care
  • Telehealth / virtual visit
  • Behavioral or mental health
  • Other
Q11
객관식

Which of the following support channels did you use to get help? Select all that apply.

  • Phone call
  • Patient portal messages
  • Email
  • Text / SMS
  • In-person nurse line or walk-in
  • 24/7 helpline
  • Support group or peer navigator
  • None of the above
  • Other
Q12
객관식

Were your questions answered in a way you could understand?

  • Yes, completely
  • Yes, somewhat
  • No
  • I did not have questions
Q13
객관식

Before you left, did you have a clear plan for your next steps in care?

  • Yes, a written plan
  • Yes, a verbal plan only
  • Partly
  • No
  • Not applicable
Q14
의견 척도

How likely are you to recommend this clinic or care team to a friend or family member?

척도: 010
최소:Not at all likely최대:Extremely likely
Q15
장문형

What went particularly well during your most recent visit?

Q16
객관식

Which best describes your gender?

  • Woman
  • Man
  • Non-binary
  • Another identity
  • Prefer not to say
Q17
객관식

Which of the following educational resources did you find useful during or after your visit? Select all that apply.

  • Printed handouts or brochures
  • Videos or multimedia content
  • Patient portal articles or guides
  • Verbal explanations from a provider
  • Online resources recommended by the care team
  • Mobile app or digital tools
  • None of the above
  • I was not offered educational resources
  • Other
Q18
드롭다운

If you were referred to another provider, approximately how long did you wait between the referral and the appointment?

  • Less than 1 week
  • 1–2 weeks
  • 2–4 weeks
  • 1–2 months
  • More than 2 months
  • I am still waiting
  • Not applicable — I was not referred
Q19
장문형

Based on your responses in this survey, is there anything else we could improve about support, education, or care coordination?

Q20
드롭다운

Where do you currently live?

  • United States
  • Canada
  • United Kingdom
  • Australia
  • India
  • Other
  • Prefer not to say
Q21
드롭다운

What is the highest level of education you have completed?

  • Less than high school
  • High school or equivalent
  • Some college or technical training
  • Bachelor's degree
  • Graduate or professional degree
  • Prefer not to say
Q22
객관식

Do you currently live with any ongoing health conditions? Select all that apply.

  • Diabetes
  • Heart or circulatory condition
  • Respiratory condition (e.g., asthma, COPD)
  • Mental health condition
  • Musculoskeletal or pain condition
  • Neurological condition
  • None of the above
  • Other
  • Prefer not to say

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • Includes an AI follow-up interview segment that adaptively probes on the specifics of each patient's experience, going beyond fixed-choice ratings
  • Separately measures three distinct dimensions—access to post-visit support, clarity of health education, and cross-provider care coordination—rather than a single general satisfaction score
  • Captures concrete process gaps such as referral wait times and which support channels or educational resources were actually used
  • Closes with open-ended questions on what went well and what could improve, giving qualitative context to the quantitative scores

SurveyMonkey

Patient Satisfaction Survey Template

This is a ready-to-field static template focused on general post-visit satisfaction rather than a deep dive into support access, education clarity, or care coordination specifically. It's backed by SurveyMonkey's established survey infrastructure and benchmarking tools. As a fixed-question format, it relies on the same question set for every respondent with no adaptive follow-up.

잘하는 점

  • Purpose-built for the post-visit patient feedback use case
  • Backed by SurveyMonkey's mature survey distribution and analytics platform
  • Likely quick to deploy with minimal setup for standard satisfaction tracking

아쉬운 점

  • Static question set with no adaptive AI probing to explore individual patient experiences further
  • No voice or conversational AI interview option to capture nuanced verbal feedback
  • No published methodology or prompt transparency for how questions were designed or scored

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