What is the Patient Satisfaction Survey template?

Measure patient experience post-visit. It is a ready-made survey with 5 questions that takes roughly 3 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

Patient Satisfaction Survey

Measure patient experience post-visit.

5 questions~3 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 50%

Quality of care received*

About this template

Patient Satisfaction Survey is a ready-to-use survey template with 5 questions that takes about 3 minutes to answer. Measure patient experience post-visit.

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

Product and feature feedback
Likelihood to recommend
Scored ratings you can trend over time
A clean split you can segment every other answer by
Open-ended feedback in respondents’ own words

Every question in this template

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

Quality of care received*
Star rating
Why this matters: A scale answer about the product itself takes a second to give, which is most of why respondents reach the end of this template at all.
Time spent with provider*
Star rating
Why this matters: Turns a subjective impression into a score you can trend over time and compare across teams or locations.
Ease of scheduling*
Star rating
Why this matters: A scored answer is the part of this template you can chart — the open questions explain the movement, this one detects it.
Would you recommend us to others?*
Yes / No
Why this matters: A clean yes or no on likelihood to recommend you. Nothing to interpret, and it doubles as a filter you can split every other answer by.
Anything else to share?
Long text
Why this matters: Unprompted wording surfaces problems you did not think to ask about — the ones no fixed-option question in this template would have caught.

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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