Patient Health Literacy & Plain Language Assessment
Measures how well patients understand medical information across print, digital, and telehealth channels. Designed for healthcare communicators seeking to identify comprehension barriers and optimize plain-language materials.
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
25
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
Thank you for taking part in this survey about understanding health information.
Your responses are voluntary and confidential — you may stop at any time. There are no right or wrong answers; we are interested in your honest opinions. Your answers will be combined with those of other participants and reported only in aggregate.
This survey takes approximately 8 minutes. Please think about your most recent clinic, hospital, or telehealth visit in the last 12 months as you answer.
Q2
Multiple Choice
In the last 12 months, have you had at least one clinic, hospital, or telehealth visit?
Yes
No
Q3
Multiple Choice
Which language do you prefer for health information?
English
Spanish
Chinese
Vietnamese
Arabic
Other (please specify)
Q4
Opinion Scale
How confident are you in your ability to fill out medical forms by yourself?
Range: 1 – 7
Min: Not at all confidentMid: NeutralMax: Extremely confident
Q5
Opinion Scale
Overall, how easy or difficult was it to understand the written health information you received in the last 12 months?
Range: 1 – 7
Min: Very difficultMid: NeutralMax: Very easy
Q6
Multiple Choice
In the last 12 months, which types of health information were difficult for you to understand? (Select all that apply)
Appointment reminders
Consent forms
Discharge or visit instructions
Bills and statements
Lab or test results
Medication labels or instructions
Insurance or coverage documents
None of these were difficult
Q7
Long Text
Please list any medical words, phrases, or sections of documents that were confusing to you in the last 12 months.
Max chars
Q8
Multiple Choice
In the last 12 months, did you use a patient portal or app to view your health information?
Yes
No
Q9
Opinion Scale
How clear was the health information displayed on the patient portal or app?
Range: 1 – 7
Min: Not at all clearMid: NeutralMax: Extremely clear
Q10
Multiple Choice
In the last 12 months, did you have any telehealth (video or phone) visits?
Yes
No
Q11
Opinion Scale
During your telehealth visits, how often did you fully understand what to do after the visit ended?
Range: 1 – 7
Min: NeverMid: NeutralMax: Always
Q12
Multiple Choice
Which of the following do you currently have access to? (Select all that apply)
Smartphone
Computer or tablet
Home internet or Wi-Fi
Screen reader or text-to-speech software
None of these
Q13
Multiple Choice
Which of the following would help you when reading health information? (Select all that apply)
Larger text or print
Audio versions or text-to-speech
Captions on videos
High-contrast colors
None of these
Q14
Ranking
Please rank the following from most to least preferred for receiving important health instructions or results.
Drag to order (top = most important)
Printed handout
Text or SMS
Patient portal or app
Email
Phone call or voicemail
Short video
In-person demonstration
Q15
Multiple Choice
Which of the following formats help you understand health information best? (Select all that apply)
Bullet-point lists
Step-by-step checklists
Pictures or diagrams
Simple real-life examples
Medical term with plain-language definition
Translated materials in my language
Large print
Q16
Multiple Choice
Which of the following materials would you most like to have available in your preferred language? (Select all that apply)
Appointment reminders
Consent forms
Visit or discharge instructions
Bills and statements
Lab or test results
Medication labels
Q17
Ranking
If we could simplify only a few areas of health information, which would help you the most? Please rank from most to least important.
Drag to order (top = most important)
Medication instructions
Test and lab results
Insurance and billing
Consent and legal forms
Discharge and follow-up instructions
Appointment scheduling
Q18
Long Text
Based on your responses in this survey, is there anything else that would make health information easier for you to understand?
Max chars
Q19
AI Interview
We'd like to learn a bit more about your experience. An AI interviewer will ask you a couple of follow-up questions about understanding health information.
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 6
Q20
Dropdown
What is your age?
18–24
25–34
35–44
45–54
55–64
65–74
75 or older
Prefer not to say
Q21
Multiple Choice
How do you describe your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Q22
Dropdown
What is the highest level of education you have completed?
Less than high school
High school or GED
Some college or trade school
Associate degree
Bachelor's degree
Graduate or professional degree
Prefer not to say
Q23
Dropdown
What is your current employment status?
Full-time
Part-time
Self-employed
Homemaker or caregiver
Student
Retired
Not currently employed
Prefer not to say
Q24
Dropdown
In which country do you currently live?
United States
United Kingdom
Canada
Australia
Other
Prefer not to say
Q25
Chat Message
Thank you for participating. Your feedback helps us make health information clearer and easier to use for everyone.
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.
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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?
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What are the pricing plans?
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