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Hospital Satisfaction Survey
This template is a patient satisfaction survey form designed to collect overall satisfaction and experiences from patients or caregivers visiting the hospital for outpatient treatment and examinations. It is structured to identify strengths and areas for improvement by evaluating key aspects such as medical services, nursing care, hospital environment, procedural convenience, and staff attitude. This serves as a practical feedback tool to enhance hospital operations and achieve patient-centered care.

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Design a form for you.
Design a form to perfectly match
your brand and purpose.
Integrate with everything.
Connect Walla with the tools you already use—like Google Sheets,
Gmail, and Notion — and keep working in your familiar workflow.
Hospital Satisfaction Survey
,
Why wouldn't you try?
Why Should You Use the Hospital Satisfaction Survey Template?
It is used to directly gather feedback from patients and caregivers to improve the quality of medical services and the hospital environment. By collecting not only objective indicators but also subjective experiences, it provides practical support for patient-centered hospital management.
How Is the Hospital Satisfaction Survey Template Structured?
Starting with general information such as department, whether it is the first visit, gender, and age, it consists of seven sections covering satisfaction with doctors and nurses, internal and external hospital environment, reservation and registration procedures, staff responsiveness, reasons for choosing the hospital, overall satisfaction, and an open-ended feedback section. Most items are formatted with a 5-point scale and short-answer selections, making them easy to complete.
Can It Be Customized to Fit the Hospital’s Needs?
Absolutely. The list of departments, evaluation items, and wording can be freely modified according to the hospital’s characteristics and operational standards. The design can also be customized to include the hospital’s logo and colors. Response results are summarized in real time and can be utilized for quality management or public reporting purposes.
Hospital Satisfaction Survey
,
Why wouldn't you try?
Why Should You Use the Hospital Satisfaction Survey Template?
It is used to directly gather feedback from patients and caregivers to improve the quality of medical services and the hospital environment. By collecting not only objective indicators but also subjective experiences, it provides practical support for patient-centered hospital management.
How Is the Hospital Satisfaction Survey Template Structured?
Starting with general information such as department, whether it is the first visit, gender, and age, it consists of seven sections covering satisfaction with doctors and nurses, internal and external hospital environment, reservation and registration procedures, staff responsiveness, reasons for choosing the hospital, overall satisfaction, and an open-ended feedback section. Most items are formatted with a 5-point scale and short-answer selections, making them easy to complete.
Can It Be Customized to Fit the Hospital’s Needs?
Absolutely. The list of departments, evaluation items, and wording can be freely modified according to the hospital’s characteristics and operational standards. The design can also be customized to include the hospital’s logo and colors. Response results are summarized in real time and can be utilized for quality management or public reporting purposes.
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