What is the Patient Satisfaction Survey template?

Standard HCAHPS-style patient experience survey. It is a ready-made survey with 6 questions that takes roughly 4 minutes to complete, and you can send it as it is or edit every question first.

Who should use this survey template?

Hospitals, clinics, diagnostic centres, pharmacies and telemedicine providers.

Can I change the questions in this template?

Yes. Using the template creates your own copy, which is completely independent of the original — you can reword or delete any question, change question types, add new ones, apply your logo and brand colours, add conditional logic, and edit the thank-you page. The original template is never modified.

Is this template free?

Previewing it is free and needs no account. Creating your own copy needs a SurveyKar account, and the free plan covers the common question types. A few templates use advanced question types that are included on paid plans.

How do I share the survey once I have customised it?

Publish it and share the link directly, print the QR code, embed it on your website, or send it to a contact list by email or WhatsApp. Responses appear in your dashboard as they arrive.

Healthcare

Survey

Featured

Patient Satisfaction Survey

Standard HCAHPS-style patient experience survey.

6 questions~4 min

Free to preview — no account needed. Using it creates your own editable copy.

Try the template

These are the real questions. Nothing you answer here is saved or submitted.

Question 1 of 60%

Rate your overall visit*

About this template

Patient Satisfaction Survey is a ready-to-use survey template with 6 questions that takes about 4 minutes to answer. Standard HCAHPS-style patient experience survey.

Healthcare templates cover patient satisfaction, discharge follow-up, telemedicine and pharmacy experience. They are deliberately short: a patient completing a survey is often unwell, tired, or waiting for someone else. Keep clinical detail out of the questionnaire and collect only what you will act on — anything identifying belongs in your clinical system, not in a feedback form. Everything in this template is editable — treat the questions below as a starting point that already has the structure right, then cut what does not apply to you.

Who should use it: Hospitals, clinics, diagnostic centres, pharmacies and telemedicine providers.
When to use it: After discharge, after a consultation, or as a periodic check on a service line.

What this template helps you measure

Staff performance
Speed and waiting times
Likelihood to recommend

Every question in this template

6 questions, with what each one is doing there. Change or remove any of them after you make your copy.

Rate your overall visit*
Star rating
Why this matters: Quick to answer and quick to read: the kind of question that keeps a response rate healthy.
Doctor's communication*
Star rating
Why this matters: Scoring how your people performed separately stops one weak area from being averaged away inside a single overall rating.
Staff courtesy*
Star rating
Why this matters: Gives you a baseline for how your people performed — the number that makes the next round of answers mean something.
Wait time*
Star rating
Why this matters: Gives you a baseline for speed and waiting time — the number that makes the next round of answers mean something.
Would you recommend this clinic?*
Net Promoter Score
Why this matters: The recommendation question is the one most teams already benchmark, which makes this the number you can compare against a target instead of only against last month.
Comments
Long text
Why this matters: The scored questions tell you something moved; this is the one that tells you what to do about it.

How to use this template

1
Start with the template
Click "Use this template" and SurveyKar creates your own copy of Patient Satisfaction Survey, with every question already in place. The original template stays untouched.
2
Customise the questions
Reword anything that does not match your business, delete what you do not need, change a question type, or add your own. Shorter surveys finish more often — cut before you add.
3
Add your branding
Set your logo, brand colours, fonts and background so the page looks like it belongs to you rather than to a survey tool.
4
Share it
Publish, then share the link, print the QR code, embed it on your site, or send it to a contact list over email or WhatsApp.
5
Read the responses
Results land in your dashboard as they arrive, with charts per question, filters, sentiment analysis on open text, and CSV or PDF export.

What you can customise

Your copy is yours. Nothing in the template is locked, and the original is never changed by anything you do.

Questions and wording

Edit, reorder, delete or add questions. Nothing in the template is locked.

Question types

Swap a rating for NPS, a single choice for a matrix, or add ranking, sliders and file uploads.

Logo and brand colours

Apply your logo, primary colour, fonts and background image to the respondent page.

Conditional logic

Skip questions or branch to a different page based on an earlier answer. Available on the Basic plan and above.

Thank-you page

Write your own closing message, or redirect respondents to a URL of your choice after submitting.

Sharing and distribution

Share by link or QR code, embed it on your website, or send it out over email and WhatsApp campaigns.

Frequently asked questions

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