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Healthcare Patient Experience Checklist: Satisfaction & Feedback

Boost patient satisfaction & improve care delivery! This Healthcare Patient Experience Checklist helps you identify key touchpoints, gather valuable feedback, and drive meaningful improvements in your patient journey. Ensure every interaction reflects your commitment to exceptional care.

Diese Vorlage wurde 4 Mal installiert.

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Pre-Appointment Communication

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Assesses clarity and ease of scheduling, reminders, and pre-appointment instructions.

Was the scheduling process easy to navigate?

Appointment Date

Scheduled Appointment Time

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Did you receive appointment reminders?

Reminder Method(s)

Please describe any difficulties experienced during scheduling.

Arrival & Check-In

2 of 7

Evaluates the efficiency and friendliness of the check-in process and waiting area experience.

Arrival Time

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Check-In Method

Wait Time (Minutes)

Staff Friendliness

Comments on Check-In Experience

Clinical Encounter

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Focuses on provider communication, empathy, and the patient's understanding of their care plan.

Did the provider introduce themselves?

Did the provider explain the diagnosis and treatment options clearly?

Describe the provider's communication style (e.g., empathetic, rushed, dismissive)

Rate the provider's level of empathy (1-10, 10 being highest)

Did you feel your questions were addressed adequately?

Please describe any concerns or uncertainties you have about your care plan.

Facility Environment

4 of 7

Considers cleanliness, comfort, and overall aesthetics of the healthcare facility.

Temperature (Waiting Area)

Cleanliness of Waiting Area

Noise Level

Describe any odors noticed

Lighting Adequacy

Location of Hand Sanitizer Stations

Billing & Financial Communication

5 of 7

Examines clarity and transparency in billing practices and financial explanations.

Was the billing process easy to understand?

Estimate of total bill amount (if known)

Were payment options clearly explained?

Please describe any confusion or concerns about your bill.

Were financial assistance options discussed (if applicable)?

Date bill was received

Post-Visit Follow-Up

6 of 7

Covers responsiveness to questions, appointment scheduling, and ongoing support.

Next Appointment Scheduled?

Time of Follow-Up Call (if applicable)

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Was the patient provided with clear discharge instructions?

Was the patient’s medication reconciliation complete?

Additional Notes on Patient Follow-Up (e.g., specific instructions given, concerns raised)

Did the patient express any concerns during the follow-up?

Patient Feedback Mechanisms

7 of 7

Evaluates the availability and effectiveness of channels for patients to share their experiences.

How would you prefer to provide feedback?

On a scale of 1-10 (1 being not at all, 10 being extremely), how satisfied were you with the feedback process?

Please describe what we could do to improve our feedback process.

Which of the following best describes your experience?

Date of Feedback Submission

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