Q01
Long Text
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Oncology Patient Experience & Care Coordination Survey
Measures oncology patient perceptions of care access, appointment scheduling, provider coordination, and navigation support services. Designed for healthcare systems seeking to identify actionable gaps across the oncology care journey.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
26 questions · ~4 min
Q02
Long Text
When was your most recent oncology appointment?
Q03
Long Text
Overall, how easy has it been to access the oncology care you needed in the last 3 months?
Q04
Long Text
In the last 3 months, my care providers communicated well with each other about my treatment.
Q05
Multiple Choice
In the last 6 months, which navigation or support services did you use? Select all that apply.
Q06
Long Text
Based on your experiences described in this survey, what could we improve to make navigating and coordinating your oncology care easier?
Q07
Long Text
What is your age?
Q08
Long Text
Thank you for completing this survey. Your feedback is invaluable and will be used to improve oncology care access, scheduling, and coordination for patients like you.
Q09
Multiple Choice
In the last 6 months, which types of oncology care did you use? Select all that apply.
Q10
Multiple Choice
How did you schedule your most recent oncology appointment?
Q11
Long Text
In the last 3 months, I felt well-informed about what to expect at each stage of my care.
Q12
Long Text
Overall, how helpful were the navigation or support services you used?
Q13
AI Interview
We'd like to learn more about your oncology care experience. An AI moderator will ask you a couple of follow-up questions based on your responses.
Q14
Multiple Choice
Which best describes your gender?
Q15
Long Text
For your most recent appointment, how easy was it to get a convenient date and time?
Q16
Long Text
In the last 3 months, transitions between different providers or departments went smoothly.
Q17
Long Text
In the last 3 months, how clear was the information you received about your treatment options?
Q18
Long Text
What is your country of residence?
Q19
Long Text
Approximately how long did you wait between scheduling and attending your most recent oncology appointment?
Q20
Multiple Choice
Is there one person who helps coordinate your oncology care across providers?
Q21
Multiple Choice
In the last 3 months, which ways did your care team communicate with you between visits? Select all that apply.
Q22
Long Text
What is the highest level of education you have completed?
Q23
Multiple Choice
In the last 3 months, which of the following made it difficult to arrange your oncology care? Select all that apply.
Q24
Multiple Choice
After your most recent visit, did you receive a written or electronic care plan with next steps?
Q25
Multiple Choice
What is your current employment status?
Q26
Multiple Choice
Which racial or ethnic groups do you identify with? 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.