Measures patient satisfaction across scheduling, wait times, provider interaction, and telehealth quality using NPS and multi-dimensional experience scales for healthcare organizations seeking actionable improvement insights.
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
Template Overview
22
Questions
AI-Powered
Smart Analysis
Ready-to-Use
Launch in Minutes
This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.
Sample Survey Items
Q1
Chat Message
Welcome to the Post-Visit Patient Experience Survey.
We'd like to learn about your most recent healthcare appointment. Your honest feedback helps improve patient care.
• This survey takes approximately 6–8 minutes.
• There are no right or wrong answers — we value your personal experience.
• Your responses are confidential and will be reported only in aggregate.
• Participation is voluntary, and you may stop at any time.
Please proceed when you are ready.
Q2
Dropdown
When was your most recent healthcare appointment?
Within the last 7 days
8–30 days ago
1–3 months ago
3–6 months ago
More than 6 months ago
Q3
Multiple Choice
How did you schedule that appointment?
Phone call to the clinic
Patient portal or mobile app
Clinic or health system website (online form)
In person at the clinic
My provider/clinic scheduled it for me
Other
Q4
Opinion Scale
How easy or difficult was it to schedule your appointment?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q5
Multiple Choice
What type of visit was your most recent appointment?
In person (at clinic or hospital)
Video/telehealth (with video)
Phone (audio only)
Q6
Opinion Scale
How satisfied were you with the wait time before your appointment began?
Range: 1 – 7
Min: Very dissatisfiedMid: NeutralMax: Very satisfied
Q7
Opinion Scale
If your visit used phone or video, how would you rate the overall technology experience (audio quality, video clarity, ease of connecting)? If your visit was in person, please skip this question.
Range: 1 – 7
Min: Very poorMid: NeutralMax: Excellent
Q8
Chat Message
We'd like you to think about your interaction with your provider during your most recent visit. Please indicate how much you agree or disagree with each of the following statements.
How clear were your next steps (e.g., medications, tests, follow-up appointments) after the visit?
Range: 1 – 7
Min: Very unclearMid: NeutralMax: Very clear
Q14
Opinion Scale
Overall, how satisfied are you with your most recent healthcare visit?
Range: 1 – 7
Min: Very dissatisfiedMid: NeutralMax: Very satisfied
Q15
Opinion Scale
How likely are you to recommend this clinic or provider to a friend or family member?
Range: 0 – 10
Min: Not at all likelyMid: NeutralMax: Extremely likely
Q16
Long Text
Please share one thing that went well and one thing that could be improved about your visit.
Max chars
Q17
AI Interview
Based on your responses, we'd like to explore your visit experience a bit further. Please share your thoughts in a brief conversation.
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 4
Q18
Chat Message
Finally, a few optional questions about you for analysis purposes.
Q19
Dropdown
What is your age group?
18–24
25–34
35–44
45–54
55–64
65 or older
Prefer not to say
Q20
Multiple Choice
Which gender do you identify with?
Woman
Man
Non-binary
Prefer not to say
Q21
Dropdown
In which country or region do you currently live?
United States
Canada
United Kingdom
Australia
Germany
France
India
Other (please specify)
Prefer not to say
Q22
Chat Message
Thank you for completing this survey. Your feedback is valuable and will be used to improve the care experience for all patients.
Frequently Asked Questions
What is QuestionPunk?
QuestionPunk is a lightweight survey platform for live AI interviews you control. It's fast, flexible, and scalable—adapting every question in real time, moderating responses across languages, letting you steer prompts, models, and flows, and even generating surveys from a simple prompt. Get interview-grade insight with survey-level speed across qual and quant.
How do I create my first survey?
Sign up, then decide how you want to build: let the AI generate a survey from your prompt, pick a template, or start from scratch. Choose question types, set logic, and preview before sharing.
How can I share surveys with my team?
Send a project link so teammates can view and collaborate instantly.
Can the AI generate a survey from a prompt?
Yes. Provide a prompt and QuestionPunk drafts a survey you can tweak before sending.
How long does support typically take to reply?
We reply within 24 hours—often much sooner. Include key details in your message to help us assist you faster.
Can I export survey results?
Absolutely. Export results as CSV straight from the results page for quick data work.