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Healthcare Appointment Scheduling & Reminder Survey

Patient scheduling survey template: measure satisfaction with booking, confirmations, and SMS/email reminders. Reduce no-shows and improve scheduling.

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

Sample Survey Items

Q1
Chat Message
Welcome! Please think about your most recent healthcare appointment within the last 6 months.
Q2
Multiple Choice
How did you book that 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
Q3
Opinion Scale
Overall, how easy was it to book your appointment?
Range: 1 – 10
Min: Very difficultMid: NeutralMax: Very easy
Q4
Multiple Choice
Which reminder types 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
Q5
Multiple Choice
How helpful were the reminders for keeping or preparing for your visit?
  • Very helpful
  • Somewhat helpful
  • Neither helpful nor unhelpful
  • Somewhat unhelpful
  • Not at all helpful
  • I did not receive any reminders
Q6
Dropdown
When do you prefer to receive appointment reminders?
  • Same day (morning of the appointment)
  • 1 day before
  • 2 to 3 days before
  • About 1 week before
  • Multiple reminders (for example, 3 days and 1 day before)
Q7
Matrix
How easy or difficult were these actions for your appointment?
RowsVery difficultSomewhat difficultNeither easy nor difficultSomewhat easyVery easyNot applicable
Booking a new appointment••••••
Rescheduling an appointment••••••
Canceling an appointment••••••
Q8
Multiple Choice
Which, if any, made scheduling harder? 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
  • None of the above
Q9
Multiple Choice
Attention check: To confirm you are paying attention, please select "I agree."
  • I agree
  • I disagree
Q10
Rating
Overall, how satisfied are you with the scheduling and reminder process?
Scale: 11 (star)
Min: Very dissatisfiedMax: Very satisfied
Q11
Long Text
What is one thing that would make scheduling or reminders better for you?
Max 600 chars
Q12
Dropdown
What is your age group?
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older
  • Prefer not to say
Q13
Multiple Choice
Which of the following best describes your gender?
  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q14
Short Text
Country/region where you live:
Max 100 chars
Q15
Dropdown
What is the highest level of education you have completed?
  • Less than high school
  • High school or equivalent
  • Some college or associate degree
  • Bachelor's degree
  • Postgraduate degree
  • Prefer not to say
Q16
Multiple Choice
What is your current employment status?
  • Employed full-time
  • Employed part-time
  • Self-employed
  • Unemployed
  • Student
  • Retired
  • Homemaker/caregiver
  • Prefer not to say
Q17
Multiple Choice
What type of health coverage do you currently have?
  • Private insurance
  • Public/government plan
  • None/self-pay
  • Prefer not to say
Q18
Long Text
Any other comments about your scheduling or reminder experience?
Max 600 chars
Q19
AI Interview
AI Interview: 2 Follow-up Questions on Patient Scheduling and Reminders
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Q20
Chat Message
Thank you for your time—your feedback helps improve scheduling and reminders.

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