.
Patient Questionnaire
Please take a few minutes of your time to complete the following questionnaire.
Start
Secured
Survio
Create a survey
Patient questionnaire
1
Which hospital department are you visiting?
Continue
Create a survey
Patient questionnaire
2
How would you rate the overall patient outcomes (e.g., recovery rates, mortality rates)?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
3
How effective do you find the treatments and procedures offered?
Please select the level of effectiveness of the treatments and procedures.
Poor
Fair
Good
Very Good
4
How would you rate the hospital's patient safety measures?
Please select the level of effectiveness of the treatments and procedures.
Poor
Fair
Good
Very Good
5
How efficient is the hospital in terms of patient wait times?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
6
How productive do you find the hospital staff?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
7
How satisfied are you with the overall patient experience?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
8
How engaged do you feel in your care decisions?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
9
How accessible are the hospital services (e.g., ease of scheduling appointments)?
Please select the rating that best represents your opinion on patient outcomes.
Poor
Fair
Good
Very Good
Excellent
Submit
Create a survey