Satisfaction survey template
How we treated you and how we informed you
A ready-to-use satisfaction survey template with 10 questions already written and tested. Open it, brand it as your own and launch in minutes. Free to start, no card required.
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
We want to know how you felt you were treated during your visit: whether you were listened to, whether you understood what was explained to you and whether your privacy was respected. We do not ask what you were seen for. About 3 minutes.
What this template asks
- Yes / NoHave you been to the clinic in the last four weeks?
- Yes
- No
- Single choiceWas this your first visit to this clinic?
- Yes, it was my first time
- No, I had been here before
- I come regularly
- MatrixThinking about the professional who saw you, how far do you agree with these statements?
- They listened without interrupting me
- They explained things in language I understood
- They gave me time and space to ask questions
- They checked that I had understood the information
- They involved me in decisions about my care
- They treated me with respect and without judging me
- They protected my privacy during the visit
- Strongly disagree
- Disagree
- Neither agree nor disagree
- Agree
- Strongly agree
- ScaleHow were you treated by the reception and administrative staff?
Very poorly 1–5 Very well
- Single choiceWhen the visit ended, were you clear about the next steps?
- Yes, completely
- Only partly
- No, I left with unanswered questions
- There were no next steps to clarify
- I do not remember
- Yes / NoWas there any moment during the visit when you did not feel well treated?
- Yes
- No
- Open textWhat happened? Tell us only about the way you were treated, with no clinical details.
- ScaleOverall, how satisfied are you with the way you were treated and informed?
Very dissatisfied 1–5 Very satisfied
- Multiple choiceWhat would most improve your next visit?
- More time to ask questions
- Simpler explanations
- Written information to take home
- More privacy in the consulting room and the waiting area
- Being told when there is a delay
- A warmer manner
- Nothing, I was treated appropriately
- Open textIs there anything else about the way you were treated or informed that you would like to tell us?
Frequently asked questions
- What is a satisfaction survey template?
- It is a pre-built satisfaction survey questionnaire with 10 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.