Satisfaction survey template
Clinic: patient experience
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
Post-visit survey: care received, ease of getting an appointment, case follow-up, and recommendation. Confidential responses.
What this template asks
- Open textWhat's your name?Just your first name. Your answers are kept confidential.
- Single choiceWhat type of visit did you have today?
- First visit
- Check-up or follow-up
- Diagnostic test
- Other matter
- Scale{{P1}}, how would you rate the care you received today?
Very poor 1–5 Very good
- Open textWe're sorry the care wasn't what you expected, {{P1}}. What happened?Tell us in your own words; the clinic's management will review it.
- Multiple choiceWhat would you highlight about your visit?You can select several.
- Staff treatment
- Punctuality
- Clarity of explanations
- Facilities
- Ease of getting an appointment
- ScaleWas it easy to get this appointment?
Very difficult 1–5 Very easy
- Single choiceIf you'd like us to follow up on your case, how would you prefer we contact you?
- By phone
- By email
- No follow-up needed
- Open textLeave us a phone number and we'll call you during consultation hours.
- EmailWhat email can we write to you at?
- ScaleWould you recommend our clinic to a family member or friend?
Definitely not 0–10 Definitely yes
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.