Outpatient Satisfaction and OPD Feedback Form Template

OPD Feedback Form Template Questions

1. 1. Please rate your overall satisfaction with your outpatient experience

This question captures the patient's entire OPD experience at a glance. It offers a quick measure of overall satisfaction, helping you gauge how well your facility meets patient expectations from start to finish.

1. 2. How likely are you to recommend our clinic/hospital to your family or friends?

• 0 (Not at all likely)

• 10 (Extremely likely)

  • This NPS survey question assesses patient loyalty and trust, indicating how likely they are to advocate for your facility. High scores here reflect strong patient confidence in your care, while lower scores highlight areas to strengthen.

1. 3. Please rate the following aspects of your outpatient experience

Waiting Time

• Very Poor

• Poor

• Average

• Good

• Excellent

Staff Friendliness

• Very Poor

• Poor

• Average

• Good

• Excellent

Cleanliness and Hygiene

• Very Poor

• Poor

• Average

• Good

• Excellent

Clarity of Instructions

• Very Poor

• Poor

• Average

• Good

• Excellent

Quality of Care

• Very Poor

• Poor

• Average

• Good

• Excellent

This likert Scale question targets crucial parts of the patient experience like waiting time, staff friendliness, cleanliness, clarity of instructions, and care quality, highlighting strengths and improvement areas. With this patient satisfaction survey, you can make focused changes that create a more seamless, satisfying visit for patients.

1. 4. How would you rate the experience with the doctor who attended to you?

• Very Poor

• Poor

• Average

• Good

• Excellent

This question focuses on the patient’s interaction with their doctor, a key component of trust and comfort in care. This patient satisfaction survey template reveals insights into the doctor’s overall experience to address patient needs.

1. 5. Was the appointment booking process convenient and efficient?

• Yes
• No

This question evaluates the accessibility and ease of the booking process, giving you feedback on an often-overlooked touchpoint. Enhancing convenience here can improve the patient experience before they even enter your facility through patient satisfaction survey.

1. 6. How would you rate the ease of finding information about our clinic/hospital (e.g., location, services)?

• Very Poor

• Poor

• Average

• Good

• Excellent

Assessing the ease of access to essential information helps you understand if patients can easily navigate your services like medical treatment provided. Clear, accurate information reduces stress, improves patient confidence, and supports better patient flow.

1. 7. Did you receive timely reminders or notifications regarding your appointment?

• Yes
• No

Timely communication shows patients that their time is valued. With this question, you can measures the efficiency of your reminder system, helping reduce missed appointments and enhancing patient satisfaction through proactive service.

1. 8. Were the facilities and amenities at the clinic/hospital adequate and comfortable?

• Yes
• No

This question captures patient impressions of the clinic’s physical environment. It highlights how welcoming, clean, and comfortable your facility feels, directly impacting the patient’s overall comfort and perception of care.

1. 9. Did the healthcare provider explain your diagnosis and treatment plan clearly?

• Yes
• No

Patients value clarity, especially regarding their health through medical professionals. This question ensures providers are effectively communicating treatment plans, which improves understanding, adherence, and patient trust in your facility’s care.

1. 10. Were all your questions and concerns addressed during your visit?

• Yes
• No

Knowing that all concerns are addressed fosters trust and satisfaction. This question confirms if patients feel truly heard, revealing opportunities to improve communication and personalized care.

1. 11. Please provide any additional comments or suggestions for improvements

Open-ended feedback offers valuable insights into patient needs that standard questions may not capture. Patients can share specific suggestions, providing a roadmap for actionable improvements in patient care.

1. 12. Would you like to be contacted for further feedback or follow-up?

• Yes
• No

This question determines a patient’s willingness for follow-up, enabling your team to gather patient feedback and show a commitment to continuous improvement in patient care.

1. 13. Personal Information

• Full Name
• Contact Number
• Email Address
• Patient ID

Collecting essential details enables you to maintain accurate records and personalize follow-up. With clear communication channels, you can better support patients, address concerns, and foster loyalty.

Each question in this feedback form is designed to provide a comprehensive understanding of the patient’s outpatient experience. From overall satisfaction and ease of booking to doctor interactions and facility comfort, medical staff or medical practice, these insights empower your clinic to make targeted improvements. By understanding specific areas like communication, convenience, and environment, this feedback helps your healthcare team enhance patient care, build trust, and ultimately create a more satisfying experience for every patient.

Customized Questions for Deeper Patient Insights

To tailor the feedback process to your clinic’s specific needs, consider adding customized questions to gain deeper insights into patient experiences. Below are some sample questions designed to capture valuable feedback on various aspects of the outpatient journey, from initial communication to post-visit care.

Before the Visit

1. How comfortable and informed did you feel about the procedure or treatment before your appointment?

• Scale: 1-10

• Purpose: Understand if patients feel prepared and informed before their visit, highlighting any gaps in pre-visit communication.

During the Visit

1. Did you feel that the healthcare provider spent sufficient time with you to address your concerns?

• Response Options: Yes, No, Somewhat

• Purpose: Measures the provider’s attentiveness and time commitment, essential for a positive, patient-centered experience.

1. How would you rate the efficiency of our appointment process?

• Response Options: Very Inefficient, Inefficient, Neutral, Efficient, Very Efficient

• Purpose: Identifies bottlenecks in the appointment process to improve patient flow and satisfaction with medical practices with scheduling.

1. How would you rate our communication regarding any delays or changes to your appointment time?

• Response Options: Very Poor, Poor, Average, Good, Excellent

• Purpose: Evaluates the clinic’s communication about delays or schedule changes, crucial for managing patient expectations.

After the Visit

1. How satisfied were you with the follow-up care and information provided after your visit?

• Response Options: Very Unsatisfied, Unsatisfied, Neutral, Satisfied, Very Satisfied

• Purpose: Assesses the effectiveness of post-visit communication and follow-up care, ensuring patients feel supported after their appointment.

Open-Ended Feedback

1. What aspect of your experience would you most like to see improved?

• Response Options: Open-ended

• Purpose: Allows patients to suggest specific improvements, offering actionable insights that may not be covered in other questions in the patient feedback form.

Each customized question is designed to capture specific insights into key areas of the outpatient experience, from pre-visit communication to post-visit care. This targeted feedback helps the clinic make precise improvements that enhance patient satisfaction.