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Satisfaction survey template

Appointment and waiting: how easy was it to be seen

A ready-to-use satisfaction survey template with 11 questions already written and tested. Open it, brand it as your own and launch in minutes. Free to start, no card required.

11 questions · ~2 min

Use this templateSee the product

Satisfaction surveys measure how the people who already bought or used you actually feel: where you exceed expectations and where you lose customers. Send it right after the experience, while the memory is fresh, and pair the score with an open comment to learn not just how much, but why.

What respondents see

A short survey about the logistics of your last appointment: how you booked it, how long you waited and what we could do better. It takes 3 to 5 minutes.

What this template asks

  1. Yes / NoHave you attended an appointment at our clinic in the last 3 months?
    • Yes
    • No
  2. Single choiceHow did you book that appointment?
    • By phone
    • On the website or an online form
    • From the app or the patient area
    • By WhatsApp or text message
    • By email
    • In person, at reception
    • Through my insurer
    • Through another channel or I do not remember
  3. Single choiceHow long was it between booking the appointment and the day of the visit?
    • The same day
    • 1 to 2 days
    • 3 to 7 days
    • 8 to 15 days
    • 16 to 30 days
    • More than 30 days
    • I do not remember
  4. ScaleHow easy was it to get that appointment?

    Very difficult 1–5 Very easy

  5. Yes / NoDid you receive a reminder about the appointment before the day of the visit?
    • Yes
    • No
  6. NumberOn the day of the appointment, how many minutes did you wait from your scheduled time until you were seen?
  7. Yes / NoWhile you were waiting, did anyone from the team tell you about the delay or the approximate waiting time?
    • Yes
    • No
  8. Multiple choiceHow did that wait affect you? You can choose up to 3 options.
    • I was late for another commitment
    • I had to ask for more time off work
    • It cost me extra (parking, transport, care)
    • I was uncomfortable or standing while I waited
    • I had to rearrange care for someone else
    • It did not particularly affect me
  9. MatrixPlease rate these practical aspects of your visit
    • The information you received about the appointment (time, place, preparation)
    • Ease of getting there and parking
    • Signage inside the centre
    • Speed of the check-in at reception
    • Comfort of the waiting area
    • Very poor
    • Poor
    • Acceptable
    • Good
    • Very good
    • Not applicable
  10. ScaleConsidering how easy it was to book and to be seen, how likely are you to recommend our clinic to a family member or friend?

    Not at all likely 0–10 Extremely likely

  11. Open textWhat would you change to make booking an appointment and being seen easier?

Frequently asked questions

What is a satisfaction survey template?
It is a pre-built satisfaction survey questionnaire with 11 ready-to-send questions. Use it as-is or adapt it to your case in Camaleonic Survey's visual editor.
Is it free?
Yes. You can create an account and use this template for free, no card required. Paid plans add advanced analytics, live results and more.
Can I customize it?
Completely. Change questions, logic, typography and color so the survey looks like your brand, not a generic form.

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