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Patient Experience Survey: Access, Communication & Care Quality

Measures patient satisfaction across appointment access, provider communication, follow-up timeliness, and digital touchpoints for healthcare organizations seeking actionable improvement insights and NPS benchmarking.

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

23

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, and thank you for taking the time to share your experience. This brief survey asks about your most recent healthcare visit within the past 6 months and should take about 4–5 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions. All responses are confidential and will be reported only in aggregate to help us improve the care we provide.
Q2
Dropdown
When was your most recent visit or interaction with us?
  • Within the last 7 days
  • 2–4 weeks ago
  • 1–3 months ago
  • 3–6 months ago
Q3
Multiple Choice
What type of care did you receive most recently?
  • Primary care
  • Specialist visit
  • Urgent care
  • Telehealth/video visit
  • Message-only consult
  • Lab or imaging
  • Pharmacy/medication delivery
  • Other
Q4
Multiple Choice
How did you schedule or start that visit?
  • Website
  • Mobile app
  • Phone call
  • Walk-in
  • Referral link or email
  • Third-party marketplace
  • Other
Q5
Opinion Scale
Overall, how easy was it to get the care you needed?
Range: 1 7
Min: Very difficultMid: NeutralMax: Very easy
Q6
Dropdown
Approximately how long did you wait past your scheduled appointment time?
  • Seen on time or early
  • 1–10 minutes
  • 11–20 minutes
  • 21–30 minutes
  • 31–45 minutes
  • More than 45 minutes
  • Not applicable (e.g., telehealth, walk-in)
Q7
Chat Message
We'd like to understand your communication experience with your provider. Please indicate how much you agree or disagree with each statement.
Q8
Opinion Scale
My provider listened carefully to me.
Range: 1 7
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q9
Opinion Scale
My provider explained things in a way I could understand.
Range: 1 7
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q10
Opinion Scale
My provider showed respect for what I had to say.
Range: 1 7
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q11
Opinion Scale
I felt involved in decisions about my care.
Range: 1 7
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q12
Multiple Choice
After your visit, did you receive follow-up information or results?
  • Yes, within 24 hours
  • Yes, within 2–3 days
  • Yes, but later than 3 days
  • No follow-up was needed
  • No, I expected follow-up but did not receive it
Q13
Rating
Overall, how would you rate your experience with the clinician you saw?
Scale: 5 (star)
Min: PoorMax: Excellent
Q14
Opinion Scale
My main health concern was addressed or resolved during this visit.
Range: 1 7
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Q15
Opinion Scale
How likely are you to recommend our care to a friend or family member?
Range: 0 10
Min: Not at all likelyMid: NeutralMax: Extremely likely
Q16
Multiple Choice
Which of the following digital features, if any, did you use for this visit? Select all that apply.
  • Online booking
  • Secure messaging
  • View lab results
  • Prescription refill
  • Payment/checkout
  • Order tracking for meds/devices
  • None of the above
Q17
Opinion Scale
How easy was the website or app to use for your needs?
Range: 1 5
Min: Very difficultMid: NeutralMax: Very easy
Q18
Long Text
Based on your experience, what is one thing we could improve for patients like you?
Max chars
Q19
AI Interview
We'd like to learn a bit more about your visit. An AI moderator will ask you a couple of brief follow-up questions based on your responses.
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 6
Q20
Multiple Choice
What is your age group?
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q21
Multiple Choice
What is your gender?
  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q22
Dropdown
In which country do you currently reside?
  • United States
  • United Kingdom
  • Canada
  • Australia
  • European Union
  • Other country
  • Prefer not to say
Q23
Chat Message
Thank you for your feedback—your responses will help us improve care for patients like you.

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.

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