Use this template to gather feedback on how patients interpret lab results and reference ranges in patient portals. Improve clarity and satisfaction. 6–8 min.
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
Multiple Choice
In the past 12 months, how often have you viewed lab results in an online portal?
Several times a month
About once a month
Every few months
Once in the last year
Not in the last 12 months
Q2
Multiple Choice
In the past 12 months, where did you view lab results online? Select all that apply.
Hospital or health system portal
Primary care clinic portal
Lab company portal (e.g., a national lab)
Insurance portal
Emailed PDF or attachment
I haven’t viewed lab results online in the last 12 months
Q3
Rating
Overall, how confident are you in understanding your lab results when viewing them online?
Scale: 10 (star)
Min: Not at all confidentMax: Very confident
Q4
Multiple Choice
If your ALT (alanine aminotransferase) result is 45 U/L and the portal shows a reference range of 7–55 U/L, what does this most likely mean?
Your result is within the reference range
Your result is dangerously high
Your result is dangerously low
It depends; more clinical context is needed
Not sure
Q5
Matrix
Thinking about portals you used in the last 12 months, how much do you agree with the following?
Rows
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
Reference ranges are easy to find
•
•
•
•
•
Abnormal results are clearly highlighted
•
•
•
•
•
Explanations use plain language I understand
•
•
•
•
•
Graphs or trends help me interpret changes
•
•
•
•
•
Next steps are explained when results are out of range
•
•
•
•
•
Q6
Multiple Choice
In the last 12 months, have units (e.g., mg/dL vs mmol/L) ever made a result hard to understand?
Rank the features that would most help you understand your lab results (top = most helpful).
Drag to order (top = most important)
Plain-language explanation of what the result means
Clear reference range with highlighting
Clinician’s note or interpretation
Visual trend chart over time
Suggested next steps (e.g., retest, contact clinician)
Links to trusted educational resources
Q9
Multiple Choice
When you see an out-of-range result online, what do you usually do first? Select all that apply.
Send a message to my clinician
Schedule an appointment
Search online for information
Wait for a clinician note or call
Ignore if only slightly out of range
I have not had an out-of-range result
Q10
Long Text
Briefly describe a time in the last 12 months when a lab result was confusing and what would have helped.
Max 600 chars
Q11
Dropdown
What is your age?
18–24
25–34
35–44
45–54
55–64
65+
Prefer not to say
Q12
Multiple Choice
Which best describes your gender?
Woman
Man
Non-binary
Prefer not to say
Q13
Short Text
Which country do you live in?
Max 100 chars
Q14
Multiple Choice
What is the highest level of education you have completed?
Less than high school
High school or equivalent
Some college or vocational training
Bachelor’s degree
Graduate or professional degree
Prefer not to say
Q15
Multiple Choice
What is your current employment status?
Employed full-time
Employed part-time
Self-employed
Student
Homemaker or caregiver
Retired
Unemployed
Unable to work
Prefer not to say
Q16
Chat Message
Welcome! This brief survey asks about how you view and interpret lab results in online portals. Please answer based on your experience in the last 12 months.
Q17
Long Text
Any additional comments about this survey or about viewing lab results in portals?
Max 600 chars
Q18
AI Interview
AI Interview: 2 Follow-up Questions on lab results and portals
AI InterviewLength: 2Personality: Expert InterviewerMode: Fast
Q19
Chat Message
Thank you for participating—your feedback helps improve how lab results are shared and explained. You may close the survey now.
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