NHS Patient Satisfaction Survey Template

1. What is your age?

The answer should be a single choice:

1. 18-24
2. 25-34
3. 35-44
4. 45-54
5. 55-64
6. 65 or older

2. What is your gender?

The answer should be a single choice:

1. Male
2. Female
3. Non-binary
4. Prefer not to say

3. On a scale of 1 to 10, where 1 is very poor and 10 is excellent, how would you rate the quality of care you received?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

4. On a scale of 1 to 10, where 1 is very poor and 10 is excellent, how would you rate the knowledge and expertise of the healthcare professionals who provided your care?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

5. On a scale of 1 to 10, where 1 is very difficult and 10 is very easy, how easy was it to schedule appointments?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

6. On a scale of 1 to 10, where 1 is very long and 10 is very short, how were the wait times for appointments?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

7. On a scale of 1 to 10, where 1 is very poor and 10 is excellent, how would you rate the clarity and helpfulness of communication from healthcare professionals?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

8. On a scale of 1 to 10, where 1 is very poor and 10 is excellent, how would you rate the availability of information about your condition and treatment?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

9. On a scale of 1 to 10, where 1 is very inconvenient and 10 is very convenient, how convenient was the location of the healthcare facility?

The answer should be a single choice:

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
9. 9
10. 10

10. Overall, how was your experience of our service?

The answer should be a single choice:

1. Very good
2. Good
3. Neither good nor poor
4. Poor
5. Very poor
6. Don't know

11. Do you have any additional comments or feedback about your experience?

The answer should be a multi line text input.