Q01
Long Text
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Patient Scheduling & Reminder Satisfaction Survey
Evaluates patient satisfaction with healthcare appointment booking, confirmation, and reminder processes to identify friction points, optimize communication timing, and reduce no-show rates.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
19 questions · ~4 min
Q02
Multiple Choice
Have you had a healthcare appointment (in-person or telehealth) within the last 6 months?
Q03
Multiple Choice
How did you book your most recent healthcare appointment?
Q04
Multiple Choice
Which types of reminders did you receive for that appointment? Select all that apply.
Q05
Long Text
Overall, how satisfied are you with the scheduling and reminder process for your most recent appointment?
Q06
Long Text
What is your age group?
Q07
Long Text
Thank you for completing this survey. Your feedback will help improve appointment scheduling and reminder systems for patients like you.
Q08
Long Text
Overall, how easy or difficult was it to book your appointment?
Q09
Long Text
How helpful were the reminders you received in keeping or preparing for your appointment?
Q10
Long Text
How likely are you to recommend this healthcare provider's scheduling system to a friend or family member?
Q11
Multiple Choice
Which of the following best describes your gender?
Q12
Long Text
How easy or difficult was it to find an available time slot that worked for your schedule?
Q13
Multiple Choice
When would you most prefer to receive appointment reminders? Select all that apply.
Q14
Long Text
What is one thing that would make scheduling or reminders better for you?
Q15
Multiple Choice
What type of health coverage do you currently have?
Q16
Long Text
How easy or difficult was it to select your preferred provider or location?
Q17
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.
Q18
Long Text
How easy or difficult was it to confirm your appointment details (date, time, location)?
Q19
Multiple Choice
Which of the following, if any, made scheduling your appointment more difficult? Select all that apply.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.