Make a patient satisfaction survey for your clinic or GP practice
Build a patient satisfaction survey for your clinic or GP practice in chat: waiting time, staff, explanations, cleanliness, anonymous replies.
How did we do?
Tell us about your recent visit or order.
This is a real form: answer it the way a visitor would. Nothing is saved.
Use this template Describe yours in chatOpen full screenMore to start from: all form, quiz and course templates. Nothing is published until you press Publish, and every answer lands in your account with charts and a CSV.
Patients rarely write to a practice about a long wait or a rushed explanation, so the problems stay hidden until they cost you appointments or reviews. A short survey sent after a visit shows which parts of the day work and which do not, in your own words and with numbers you can compare over time. The live sample above is a general customer satisfaction survey; the chat rebuilds it around your services, staff and wording.
What you get
Anonymous by default, contact optional
The form can be set up so no name is required. Patients who want a reply can add an email on the last question, so most responses stay anonymous while you still know who to follow up with.
Logic and pages
Show a follow-up only when it applies, split a long form into pages, or show one question per screen.
Results you can read
A chart for every question, averages and NPS for scales, the order of a ranking, a table of every answer and a CSV.
How it works
- Step 1
Try the sample above, then press Use this template, or describe your own form to the chat.
- Step 2
Change any question by hand or ask the assistant ("add a question about price", "translate it to Spanish"), with a live preview.
- Step 3
Publish, share the link or QR code, and read the answers as they arrive. You get an email for each one.
Who uses it
GP practice manager
Send a link by text after appointments and look at the results page each month to see whether waiting times or reception complaints are rising before they reach the practice's complaints log.
Private physiotherapy or dental clinic owner
Ask about booking ease, how clearly the treatment plan was explained and whether the patient would recommend you, then compare the scores quarter by quarter using the CSV export.
Walk-in or minor treatment clinic
Put a QR code on a card at reception or on the waiting room screen so patients can answer on their phone before they leave, with a short form that takes under two minutes.
Questions
Can patients answer without giving their name?
Yes. The survey can be set up without any name field, and the contact question can be marked optional. Tell the chat if you want replies to be fully anonymous, and it will leave out every field that identifies a patient.
Should the survey ask about diagnosis or treatment?
Keep it to the experience: waiting, booking, staff, explanations, cleanliness and recommendation. You are responsible for what you collect, and the best practice is to avoid asking for health details you do not need to improve the service.
How do I get the survey to patients?
Publish the form and share the link or QR code by text message, email, on a printed card at checkout, or on a screen in the waiting room. You can set a response limit if you want to stop collecting at a certain number.
Can I track whether scores improve over time?
The results page shows charts for each question, and you can download all responses as a CSV file. Keeping the same core questions each period makes it possible to compare waiting time or explanation scores across months.
Does this replace an official patient survey?
No. It gives you your own feedback for improving the practice. If your local health system or regulator asks you to run a specific survey, keep doing that and use this form for the extra questions you want to test.