Patient Satisfaction Evaluation Checklist
1. Appointment Process
Task | Completed (✓) |
|---|
Ease of scheduling appointments. | |
Timeliness of appointment confirmation. | |
Availability of preferred dates and times. | |
Efficient check-in process upon arrival. | |
2. Facility Environment
Task | Completed (✓) |
|---|
Cleanliness of waiting and examination areas. | |
Comfort and accessibility of seating and amenities. | |
Availability of parking or public transport options. | |
Clear signage and directions within the facility. | |
3. Staff Interaction
Task | Completed (✓) |
|---|
Friendliness and professionalism of front desk staff. | |
Courteousness and empathy were shown by the medical staff. | |
Effective communication during interactions. | |
Respect for patient privacy and confidentiality. | |
4. Consultation Experience
Task | Completed (✓) |
|---|
Time spent by the provider to explain the diagnosis and treatment. | |
Provider’s ability to answer patient questions thoroughly. | |
Perception of provider’s knowledge and expertise. | |
Clear communication of follow-up care instructions. | |
5. Treatment and Outcomes
Task | Completed (✓) |
|---|
Satisfaction with the effectiveness of the treatment. | |
Minimal waiting times for procedures or treatments. | |
Adequate pain management or comfort measures. | |
Accessibility of prescribed medications or resources. | |
6. Feedback and Follow-Up
Task | Completed (✓) |
|---|
Opportunity to provide feedback on the experience. | |
Timeliness and effectiveness of follow-up appointments. | |
Resolution of concerns or issues raised by the patient. | |
Overall satisfaction with the care received. | |
Overall Patient Satisfaction Rating:
Additional Comments:
[Insert any additional feedback, observations, or suggestions for improvement.]
Evaluator Name: [Your Name]
[Date Signed]
Patient Name: [Patient Name]
[Date Signed]
Checklist Templates @ Template.net
