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Senior Living Family Member Satisfaction Survey

For families of residents in assisted living, memory care or skilled nursing. It measures communication, care, responsiveness to concerns and value for cost, and an AI follow-up reconstructs the last time the family raised a concern and how it was handled.

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Senior Living Family Member Satisfaction Survey

Thank you for helping us care for your family member. Your answers are confidential and help us see the community the way you do. It takes about 5 minutes.

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Default theme. Colors and fonts are yours to change.

Sample questions

A preview of what’s in the template. Every question is editable before you launch.

7 questions · ~6 min
Message

Thank you for helping us care for your family member. Your answers are confidential and help us see the community the way you do. It takes about 5 minutes.

Q01
Multiple ChoiceRequired

What is your relationship to the resident?

  • Spouse or partner
  • Son or daughter
  • Other relative
  • Friend
  • Legal guardian or representative
Q02
Multiple ChoiceRequired

How often do you visit or call?

  • Several times a week
  • About once a week
  • A few times a month
  • Once a month or less
Q03
MatrixRequired

How would you rate us on each of these?

6 rows × 5 columns
  • Keeping you informed about your family member
  • Quality of care
  • How staff treat your family member
  • Responding to your questions and concerns
  • Cleanliness and upkeep
  • +1 more
Columns: Poor · Fair · Good · Very good · Excellent
Q04
Multiple ChoiceRequired

In the last 3 months, have you raised a concern with staff?

  • Yes
  • No
Q05
Opinion Scale

If you raised a concern, how satisfied were you with how it was handled?

Scale: 1 – 5
Min:Very dissatisfiedMax:Very satisfied
Q06
Opinion ScaleRequired

How likely are you to recommend this community to a friend whose family member needs care?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q07
AI Interview

Ask about the last time the family member needed something from staff: what they asked, who answered, how long it took, and how they felt afterwards. If they rated communication or responsiveness low, find out what they would want to hear and how often. If everything was rated highly, ask what the community does that others do not.

Message

Thank you. Your answers go to our leadership team, and we share what we change in our next family update.

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.

Why this template

What this template is built to do — we found no directly comparable template from other survey tools to review.

What sets it apart

  • The AI follow-up walks through a real concern, step by step, so you see where communication broke down
  • Separate scores for care, communication and value, not one blended number
  • Pairs with the resident survey for a full picture

Frequently asked questions

What questions are in the “Senior Living Family Member Satisfaction Survey” template?

The template includes 7 ready-to-use questions, starting with: “What is your relationship to the resident?” · “How often do you visit or call?” · “How would you rate us on each of these?”. The full set is previewed above, and every question is editable.

How long does this survey take to complete?

Respondents typically finish the 7 questions in about 6 minutes.

Can I customize this template?

Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.

Is this template free to use?

Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.

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