Q01
메시지
모든 템플릿
Patient Visit Experience Survey (CAHPS-Aligned)
Measures how a patient experienced a specific provider visit — getting the appointment, provider communication, staff courtesy, and an overall rating — modeled on the CAHPS Clinician & Group Visit 2.0 survey used across medical practices and health systems. An AI follow-up interview digs into the exact moment or interaction that drove the patient's overall rating, turning a single number into an actionable story.
샘플 질문
템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.
질문 13개 · 약 7분
Q02
객관식
Was this the first time you saw this particular provider?
- Yes, first visit
- No, I've seen this provider before
Q03
객관식필수
How many days passed between when you first tried to schedule this appointment and the day you were actually seen?
- Same day
- 1-3 days
- 4-7 days
- 1-2 weeks
- More than 2 weeks
Q04
매트릭스필수
Thinking about this visit, how often did your provider do each of the following?
5개 행 × 4개 열
- Explained things in a way you could understand
- Listened carefully to you
- Seemed to know important information about your medical history
- Showed respect for what you had to say
- Spent enough time with you
열: Never · Sometimes · Usually · Always
Q05
객관식필수
Thinking about the front-desk and office staff during this visit, how often were they courteous and helpful to you?
- Never
- Sometimes
- Usually
- Always
Q06
의견 척도필수
Using a 0-10 scale, how would you rate this provider overall?
척도: 0 – 10
최소:Worst provider possible최대:Best provider possible
Q07
객관식필수
How likely are you to recommend this provider to friends and family?
- Definitely not
- Probably not
- Probably yes
- Definitely yes
Q08
AI 인터뷰
Probe why the respondent gave the overall rating they did: ask them to describe the specific moment or interaction during this visit that most shaped that score. If the rating was high, find out what exactly stood out as exceptional and worth protecting; if it was middling or low, identify the single biggest fix that would raise it and whether it traces back to the provider's communication, the wait, or the staff. Anchor every follow-up on concrete details from this specific visit rather than general impressions of the practice.
Q09
객관식
In general, how would you rate your overall health?
- Excellent
- Very good
- Good
- Fair
- Poor
- Prefer not to say
Q10
객관식
Which age range do you fall into?
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65-74
- 75 or older
- Prefer not to say
Q11
객관식
How do you describe your gender?
- Man
- Woman
- Non-binary
- Prefer not to say
Q12
드롭다운
What is the highest level of education you have completed?
- Less than high school
- High school graduate
- Some college
- Bachelor's degree
- Graduate or professional degree
- Prefer not to say
Q13
메시지
Thank you for sharing your experience! Your responses feed directly into this practice's patient experience reports and help guide improvements to scheduling, communication, and staff training.
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
- Uses the same core structure as the CAHPS Clinician & Group visit survey — appointment access, provider communication, staff courtesy, and an overall 0-10 rating — so results are benchmarkable against a recognized standard
- Pairs the overall rating with an AI follow-up interview that asks the patient to describe the exact moment or interaction that drove their score, turning a number into a specific, actionable story
- Includes a matrix question on specific provider communication behaviors and a separate staff-courtesy question, so low scores can be traced to the front desk or the clinician
- Collects standard case-mix variables (general health, age range, gender, education) so results can be segmented and fairly compared across patient groups
SurveyMonkey
Patient Satisfaction Survey TemplateA ready-to-field, static patient satisfaction survey covering visit basics and satisfaction ratings. It's a solid general-purpose template but is not explicitly modeled on the CAHPS visit survey structure and doesn't publish its underlying question methodology.
잘하는 점
- Fielding-ready template usable immediately without custom build-out
- Backed by SurveyMonkey's broad distribution, panel, and analytics infrastructure
- Familiar, easy-to-deploy survey format for healthcare practices
아쉬운 점
- Fixed question set with no adaptive follow-up to probe why a patient gave a particular rating
- No voice-based interview option for patients who prefer speaking over typing
- No automated per-response quality scoring or transparent prompt/methodology disclosure
SurveySparrow
Doctor Visit Form TemplateA conversational-style form template for capturing doctor visit details, benefiting from SurveySparrow's chat-like UI. It reads as a general visit form rather than a CAHPS-aligned experience survey, and there's no indication it drills into the reasoning behind a patient's overall rating.
잘하는 점
- Chat-style interface that can feel more conversational than a traditional form
- Fielding-ready template for quick deployment
- Mobile-friendly design typical of SurveySparrow's product
아쉬운 점
- Conversational UI is scripted, not adaptive — it can't generate a genuine follow-up question based on a specific answer
- No voice AI interview option for patients
- No mechanism to automatically score response quality or surface the exact moment driving a low or high rating
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이 템플릿을 편집기에서 열어 보세요. 첫 응답자가 보기 전에 모든 부분을 원하는 대로 바꿀 수 있습니다.