---
title: Healthcare Membership Program Value Research Form Template | Paperform
description: UX research form template for healthcare concierge programs to measure member satisfaction, track service utilization, calculate cost savings, and evaluate exclusive benefits.
url: "https://paperform.co/templates/healthcare-membership-program-value-research"
type: static
generatedAt: "2026-03-28T00:44:04.427Z"
---

[← Back to free form templates](/templates/)    ![Healthcare Membership Program Value Research](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/healthcare-membership-program-value-research.png)
    [Preview](https://_preview.paperform.co/ai-template/healthcare-membership-program-value-research) [Use this template for free](/create?ai-template=healthcare-membership-program-value-research)    [Discovery & Research Forms](/templates/category/discovery-research/)[Surveys & Questionnaires](/templates/category/surveys/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Consulting](/templates/industry/consulting/)[Healthcare](/templates/industry/healthcare/)[Research](/templates/industry/research/) [Product Manager](/templates/role/product-manager/)[Consultant](/templates/role/consultant/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Researcher](/templates/role/researcher/)     About this free form template
### Healthcare Membership Program Value Research Form Template

Understanding how members perceive and utilize your healthcare membership program is critical to improving service delivery, demonstrating ROI, and increasing retention. This **Healthcare Membership Program Value Research** form template helps healthcare organizations, concierge medical practices, and wellness programs gather actionable insights about member satisfaction, cost savings, and benefit utilization patterns.

#### Why UX Research Matters in Healthcare Membership Programs

Healthcare membership models—from concierge medicine to executive health programs—compete on value perception, not just clinical outcomes. Members need to *feel* the benefits of their investment, whether that's time saved through priority scheduling, money saved through preventive care, or peace of mind from having a dedicated care team.

This research template goes beyond basic satisfaction surveys. It helps you understand:

 - **Utilization patterns**: Which concierge services are members actually using? Which valuable benefits are going unnoticed?
 - **Cost perception**: Do members understand the financial value they're receiving through cost avoidance, negotiated rates, and preventive care?
 - **Experience gaps**: Where do member expectations diverge from service delivery?
 - **Retention drivers**: What benefits would members miss most if they cancelled?

#### Perfect for Healthcare Organizations and Wellness Programs

This template is ideal for:

 - **Concierge medicine practices** evaluating their premium service offerings
 - **Health systems** with executive health or membership programs
 - **Wellness organizations** measuring the impact of exclusive member benefits
 - **Healthcare consultants** conducting competitive analysis and program optimization
 - **Health tech companies** validating features for membership-based health platforms

Whether you're launching a new program, optimizing an existing one, or preparing renewal communications that demonstrate value, this research form provides the structured feedback you need.

#### What Makes This Template Work

**Comprehensive benefit mapping**: The form walks through different service categories—from 24/7 access and priority scheduling to health advocacy and wellness perks—capturing both usage patterns and satisfaction levels.

**Cost savings calculation**: Built-in questions help members estimate their financial savings, making the abstract value concrete. This data becomes powerful for renewal marketing and program justification.

**Qualitative + quantitative balance**: You'll collect rating scales for easy analysis alongside open-ended feedback that reveals the "why" behind the numbers.

**Utilization tracking**: Understand which benefits are hidden gems (high satisfaction, low awareness) versus which may need repositioning or retirement.

#### Automate Your Research Workflow with Stepper

Once you've collected member feedback, [Stepper](https://stepper.io) can help you act on it automatically. Connect this form to your CRM to:

 - Tag members based on their satisfaction scores and utilization patterns
 - Route "at-risk" member feedback to retention teams immediately
 - Aggregate cost savings data and auto-generate ROI reports
 - Trigger personalized follow-ups for members not utilizing key benefits
 - Create segment-specific renewal campaigns based on stated preferences

#### Design That Respects Your Members' Time

Healthcare executives and busy professionals value their time. This template uses clear, focused questions organized into logical sections. You can customize the theme to match your program's brand—whether that's clinical and trustworthy or premium and spa-like.

Consider using Guided Mode for higher completion rates, especially if you're sending this via email. Members can answer at their own pace, with one question at a time feeling less overwhelming than a long page of fields.

#### Turn Feedback Into Program Improvements

With Paperform's AI Insights, you can instantly analyze open-ended responses to identify common themes—what members love, what they're confused about, and what services they wish existed. Export your data to Excel or connect to data visualization tools to track trends over time as you implement program changes.

The data you collect becomes your roadmap for:

 - **Service enhancement**: Double down on high-value, high-satisfaction benefits
 - **Member education**: Create content around underutilized services that could solve real problems
 - **Pricing justification**: Demonstrate ROI with real member savings data
 - **Renewal strategy**: Craft messaging that speaks to what members actually value

#### SOC 2 Compliant and Professional

Healthcare data deserves careful handling. Paperform is SOC 2 Type II compliant, ensuring your member feedback is collected securely. While this form doesn't collect PHI, you can trust that your platform meets the security standards healthcare organizations require.

#### Get Started in Minutes

This template is ready to use as-is or customize to your specific program benefits. Add your logo, adjust the questions to match your service offerings, and send it to members as part of annual reviews, after onboarding, or whenever you need strategic feedback.

Trusted by healthcare organizations worldwide, this research form helps you prove program value, improve member experience, and build a healthcare membership offering that members rave about—and renew year after year.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
 ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg)
 ![G2 - 4.8 out of 5](/images/g2-st.jpg)
  [Try Paperform free now](/register)
## More templates like this
  [![Durable Medical Equipment Supplier Selection Research Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/durable-medical-equipment-supplier-selection-research-form.png)

### Durable Medical Equipment Supplier Selection Research Form

Gather insights on healthcare providers' priorities when selecting durable medical equipment suppliers, including product quality perceptions, delivery expectations, and customer service requirements.](/templates/durable-medical-equipment-supplier-selection-research-form/)
[![Allied Health Referral Coordination Research](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/allied-health-referral-coordination-research.png)

### Allied Health Referral Coordination Research

A UX research form to gather insights on specialist availability, appointment urgency, and medical record transfer efficiency in allied health referral coordination workflows.](/templates/allied-health-referral-coordination-research/)
[![Clinical Trial Patient Recruitment Portal Research Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/clinical-trial-patient-recruitment-portal-research-form.png)

### Clinical Trial Patient Recruitment Portal Research Form

A comprehensive research form to gather patient feedback on clinical trial recruitment experiences, focusing on eligibility screening, informed consent, and appointment scheduling processes.](/templates/clinical-trial-patient-recruitment-portal-research-form/)
[![Healthcare Patient Portal Usability Research Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/healthcare-patient-portal-usability-research-form.png)

### Healthcare Patient Portal Usability Research Form

A comprehensive UX research form designed to evaluate patient portal usability, assess accessibility needs, measure task success rates, and understand digital literacy levels for healthcare technology improvement.](/templates/healthcare-patient-portal-usability-research-form/)
[![Healthcare Quality Rating Interpretation Research](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/healthcare-quality-rating-interpretation-research.png)

### Healthcare Quality Rating Interpretation Research

A comprehensive UX research form to understand how patients interpret healthcare quality ratings, assess metric relevance, evaluate comparison methodologies, and identify decision-making factors.](/templates/healthcare-quality-rating-interpretation-research/)
[![Healthcare Patient Portal Feature Importance Study](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/healthcare-patient-portal-feature-importance-study.png)

### Healthcare Patient Portal Feature Importance Study

Gather insights on patient portal feature priorities including appointment scheduling, medical record access, billing preferences, and provider communication expectations to improve healthcare digital experiences.](/templates/healthcare-patient-portal-feature-importance-study/)
[![Hospice Care Family Communication Portal Research Survey](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/hospice-care-family-communication-portal-research-survey.png)

### Hospice Care Family Communication Portal Research Survey

A user research form designed to gather insights from hospice care families about their experiences with care plan visibility, provider communication, and advance directive documentation.](/templates/hospice-care-family-communication-portal-research-survey/)
[![Senior Care Facility Family Portal Research](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/senior-care-facility-family-portal-research.png)

### Senior Care Facility Family Portal Research

Gather user feedback on family portal features for senior care facilities, including preferences for resident updates, medication tracking, and billing transparency.](/templates/senior-care-facility-family-portal-research/)
[![Telehealth Service Demand Assessment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/telehealth-service-demand-assessment.png)

### Telehealth Service Demand Assessment

A comprehensive market research survey to assess demand for telehealth services, evaluate patient technology readiness, and analyze insurance coverage preferences.](/templates/telehealth-service-demand-assessment/)
[![Alternative Medicine Practitioner Booking Research Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/alternative-medicine-practitioner-booking-research-form.png)

### Alternative Medicine Practitioner Booking Research Form

Conduct user research on how patients select and book alternative medicine practitioners, exploring decision factors around treatment modalities, credentials, and insurance coverage.](/templates/alternative-medicine-practitioner-booking-research-form/)
[![Business Travel Focus Group Recruitment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/business-travel-focus-group-recruitment-form.png)

### Business Travel Focus Group Recruitment Form

Screen and recruit corporate travelers for focus groups exploring business travel experiences, booking processes, expense reporting challenges, and travel policy compliance.](/templates/business-travel-focus-group-recruitment-form/)
[![Care Coordination Platform Family Research Study](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/care-coordination-platform-family-research-study.png)

### Care Coordination Platform Family Research Study

A comprehensive UX research form for understanding family member collaboration needs, information sharing preferences, and task management clarity in care coordination platforms.](/templates/care-coordination-platform-family-research-study/)