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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 an AI-powered survey and research platform that turns traditional surveys into adaptive conversations. Describe your research goal and get a complete survey draft, conduct AI-moderated interviews with dynamic follow-ups, detect low-quality responses, and produce insights automatically. It's fast, flexible, and scalable across qualitative and quantitative research.
How do I create my first survey?
Sign up, then choose how to build: describe your research goal and let AI generate a survey, pick a template, or start from scratch. Add question types, set logic, preview, and share.
Can the AI generate a survey from a prompt?
Yes. Describe your research goal in plain language and QuestionPunk drafts a complete survey with appropriate question types, ordering, and AI follow-up logic. You can then customize before publishing.
What question types are available?
QuestionPunk supports a wide range of question types: opinion scale, rating, multiple choice, dropdown, ranking, matrix, constant sum, AI interview (text and audio), long text, short text, email, phone, date, address, website, numeric, audio/video recording, contact form, chat message, conversation reset, button, page breaks, and more.
How do AI interviews work?
AI interviews conduct adaptive conversations with respondents. The AI asks follow-up questions based on what the respondent says, probing for clarity and depth. You control the personality, tone, model (Haiku, Sonnet, or Opus), and question mode (fixed count, AI decides when to stop, or time-based).
Can I test my survey before launching?
Yes. Use synthetic testing to create AI personas and run them through your survey. This helps catch issues with question flow, logic, and wording before real respondents see it.
How many languages are supported?
QuestionPunk supports 142+ languages. Add languages from the survey editor, auto-translate questions, and share language-specific links. AI interviews also adapt to the respondent's language automatically.
How can I share my survey?
Share via a direct link (with optional custom slug), embed on your website (iframe or script), distribute through Prolific for research panels, or generate a QR code for physical distribution.
Can I export survey results?
Yes. Export as CSV (flat or wide layout), Excel (XLSX), or export the survey structure as PDF/Word. Filter by suspicious level, response type, language, or date range before exporting.
Does QuestionPunk detect fraudulent responses?
Yes. Every response is automatically classified with a suspicious level (low/medium/high) based on attention checks, response timing, and behavioral signals. You can filter flagged responses in the Responses tab.
What are the pricing plans?
Basic (Free): 20 responses/month. Business ($50/month or $500/year): 5,000 responses/month with priority support. Enterprise (Custom): unlimited responses, remove branding, custom domain, and dedicated support.
How long does support take to reply?
We reply within 24 hours, often much sooner. Include key details in your message to help us assist you faster.

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