Evaluates patient satisfaction with healthcare appointment booking, confirmation, and reminder processes to identify friction points, optimize communication timing, and reduce no-show rates.
What's Included
AI-Powered Questions
Intelligent follow-up questions based on responses
Automated Analysis
Real-time sentiment and insight detection
Smart Distribution
Target the right audience automatically
Detailed Reports
Comprehensive insights and recommendations
Template Overview
19
Questions
AI-Powered
Smart Analysis
Ready-to-Use
Launch in Minutes
This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.
Sample Survey Items
Q1
Chat Message
Welcome to this survey about your healthcare appointment scheduling experience.
Your participation is voluntary and you may stop at any time. All responses are confidential and will be reported only in aggregate — no individual answers will be shared. There are no right or wrong answers; we are simply interested in your honest opinions.
This survey takes approximately 5 minutes to complete.
Please think about your most recent healthcare appointment within the last 6 months as you answer the following questions.
Q2
Multiple Choice
Have you had a healthcare appointment (in-person or telehealth) within the last 6 months?
Yes
No
Q3
Multiple Choice
How did you book your most recent healthcare appointment?
Phone call to the clinic
Central scheduling phone line
Online patient portal
Provider's mobile app
Third-party website
Walk-in without booking
Someone else booked for me
Other (please specify)
Q4
Opinion Scale
Overall, how easy or difficult was it to book your appointment?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q5
Opinion Scale
How easy or difficult was it to find an available time slot that worked for your schedule?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q6
Opinion Scale
How easy or difficult was it to select your preferred provider or location?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q7
Opinion Scale
How easy or difficult was it to confirm your appointment details (date, time, location)?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q8
Multiple Choice
Which of the following, if any, made scheduling your appointment more difficult? Select all that apply.
Long hold times on the phone
Limited available time slots
Patient portal was hard to use
Could not find my provider in the system
Insurance or authorization confusion
Accessibility or language barriers
Privacy or security concerns
Other (please specify)
None of the above
Q9
Multiple Choice
Which types of reminders did you receive for that appointment? Select all that apply.
Text/SMS
Email
Phone call
Mobile app push notification
Patient portal message
Postal mail
I did not receive any reminders
Q10
Opinion Scale
How helpful were the reminders you received in keeping or preparing for your appointment?
Range: 1 – 5
Min: Not at all helpfulMid: NeutralMax: Very helpful
Q11
Multiple Choice
When would you most prefer to receive appointment reminders? Select all that apply.
Same day (morning of the appointment)
1 day before
2 to 3 days before
About 1 week before
More than 1 week before
Q12
Opinion Scale
Overall, how satisfied are you with the scheduling and reminder process for your most recent appointment?
Range: 1 – 7
Min: Very dissatisfiedMid: NeutralMax: Very satisfied
Q13
Opinion Scale
How likely are you to recommend this healthcare provider's scheduling system to a friend or family member?
Range: 1 – 7
Min: Very unlikelyMid: NeutralMax: Very likely
Q14
Long Text
What is one thing that would make scheduling or reminders better for you?
Max chars
Q15
AI Interview
Based on your responses, we'd like to explore your scheduling and reminder experience in a bit more depth. Please share your thoughts and our AI moderator will ask a couple of follow-up questions.
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 4
Q16
Dropdown
What is your age group?
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say
Q17
Multiple Choice
Which of the following best describes your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Q18
Multiple Choice
What type of health coverage do you currently have?
Private insurance (employer or individual)
Public/government plan (e.g., Medicare, Medicaid)
None / self-pay
Prefer not to say
Q19
Chat Message
Thank you for completing this survey. Your feedback will help improve appointment scheduling and reminder systems for patients like you.
Frequently Asked Questions
What is QuestionPunk?
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