Health Clinic Survey Template for Patient Feedback

Age

Gender, How satisfied were you with the overall quality of care you received?, How would you rate the communication skills of your healthcare provider?, How satisfied were you with the wait time before seeing your healthcare provider?, How would you rate the cleanliness and hygiene of the facility?, How satisfied were you with the availability of parking?

Occupation, Insurance Provider, Frequency of visits, What could we do to improve your healthcare experience?, Are there any specific areas where you would like to see improvements?