Q01
Message
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Mental Capacity Assessment Process Experience Survey
Captures how patients, family members, and care partners experienced a mental capacity assessment — clarity of communication, respect shown, and involvement in the final decision. Built for healthcare and social care teams reviewing how well their assessment process meets legal and ethical standards, with an AI follow-up interview that digs into what made the process feel fair, respectful, or confusing.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
12 questions · ~7 min
Q02
Multiple ChoiceRequired
Which best describes your role in this mental capacity assessment?
- The person who was assessed
- Family member or friend of the person assessed
- Professional carer or support worker
- Healthcare or social care staff involved in the assessment
- Other
Q03
Opinion ScaleRequired
Before the assessment began, how clearly was its purpose explained to you?
Scale: 1 – 5
Min:Not explained at allMax:Explained extremely clearly
Q04
MatrixRequired
Thinking about how the assessment itself was carried out, how much do you agree with each statement?
5 rows × 5 columns
- I (or the person assessed) was given enough time to express my views
- Plain, jargon-free language was used
- I had a genuine opportunity to ask questions
- Family members or supporters were appropriately involved
- My privacy and dignity were respected throughout
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
Rating ScaleRequired
Overall, how would you rate the way you (or your family member) were treated during the assessment?
Range: 1 – 5
Min:Very poorMax:Excellent
Q06
Multiple ChoiceRequired
Was the outcome of the assessment, and the reasoning behind it, explained afterward?
- Yes, fully explained
- Partly explained
- Not explained
- I don't know / not applicable
Q07
Opinion ScaleRequired
How confident are you that the final decision reflected the person's own wishes and values?
Scale: 1 – 7
Min:Not at all confidentMax:Extremely confident
Q08
AI Interview
Explore the respondent's confidence rating about whether the decision reflected the person's own wishes and values. Ask for a specific moment or exchange during the assessment that shaped that view — what the assessor said or did, and how it landed. If the outcome wasn't fully explained, probe what information they still feel is missing. If the respondent was the person assessed themselves, gently ask how it felt to be asked about their own decision-making capacity, and note any distress without pressing further if they seem uncomfortable.
Q09
Long Text
Is there anything the assessment team could have done differently to make this process feel fairer or clearer?
Q10
Multiple Choice
Which setting did the assessment take place in?
- Hospital
- Care home or residential setting
- Person's own home
- Community clinic
- Other
- Prefer not to say
Q11
Multiple Choice
What is your age range?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65-74
- 75 or older
- Prefer not to say
Q12
Message
That's everything — thank you for sharing your experience. Your responses will be combined with others (anonymously) to help the team improve how mental capacity assessments are explained and carried out.
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.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Includes a dedicated opinion-scale question on how clearly the assessment's purpose was explained, plus a matrix set on how the assessment itself was carried out — giving structured, comparable data on communication and conduct
- Pairs a numeric confidence rating ('how confident are you the final decision reflected the person's own wishes') with an AI follow-up interview that actively explores the reasoning behind that rating, surfacing nuance a static scale alone would miss
- Captures respondent role (patient, family member, care partner), assessment setting, and age range, so results can be segmented by who experienced the process and where
- Closes with an open long-text question inviting suggestions for what could have been done differently, giving qualitative detail behind the quantitative ratings
Jotform
Mental Capacity Assessment Form TemplateA static, drag-and-drop form template for recording mental capacity assessment details, aimed more at documentation than at capturing the respondent's subjective experience. It's fielding-ready but relies on fixed fields rather than any adaptive questioning. Good for internal record-keeping, less suited to exploring how the process felt to patients or families.
What it does well
- Easy drag-and-drop customization typical of Jotform's builder
- Fielding-ready template with standard form fields
- Likely supports PDF export and integrations common to Jotform forms
Where it falls short
- No adaptive AI follow-up interview to probe why a rating was given
- No voice AI interview option
- No automated per-response quality scoring or transparent prompt methodology
Typeform
Mental Capacity Assessment Form TemplateA conversational, one-question-at-a-time template that likely offers a more engaging respondent experience than a flat form. It's fielding-ready out of the box but still relies on pre-written, static questions rather than any dynamic follow-up. Reporting is generally basic dashboard-style analytics rather than narrative reports.
What it does well
- Polished conversational UI that Typeform is known for
- Fielding-ready template requiring minimal setup
- Logic jumps can tailor question order based on prior answers
Where it falls short
- No adaptive AI interview that generates follow-up questions based on a respondent's specific answer
- No voice-based AI interview capability
- No automated quality scoring of open-ended responses or published prompt transparency
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.