Hospital Patient Experience Survey
About this free form template

Hospital Patient Experience Survey Template

Measuring patient satisfaction is critical to improving healthcare quality and meeting regulatory requirements. This Hospital Patient Experience Survey template is designed to align with HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) standards, helping hospitals and healthcare facilities gather meaningful feedback about the patient experience.

What This Template Covers

This survey captures patient perspectives across all key dimensions of hospital care:

  • Nurse communication – responsiveness, courtesy, and listening skills
  • Doctor communication – explanations, respect, and engagement
  • Hospital environment – cleanliness and quietness
  • Pain management – how well pain was controlled and discussed
  • Medication explanations – clarity about new medications
  • Discharge information – preparation for post-hospital care
  • Care transitions – readiness to manage health at home
  • Overall hospital rating – likelihood to recommend and overall satisfaction

Why Use Paperform for Patient Experience Surveys?

Paperform makes it easy to collect, analyze, and act on patient feedback without complicated software or IT support. You can:

  • Customize the survey to reflect your facility's specific services and branding
  • Use conditional logic to ask follow-up questions based on patient responses
  • Embed the survey on your patient portal, send via email, or share via SMS
  • Analyze responses with AI Insights to quickly identify trends, concerns, and opportunities for improvement
  • Automate workflows with Stepper to route critical feedback to department heads, trigger follow-up calls, or log responses in your CRM or quality management system

This template is ideal for hospital administrators, patient experience teams, quality improvement coordinators, and healthcare consultants looking to meet HCAHPS benchmarks, improve patient satisfaction scores, and build a culture of continuous improvement.

Built for Healthcare Teams

Whether you're a large hospital system or a smaller healthcare facility, Paperform helps you maintain GDPR and SOC 2 compliance while keeping patient data secure. The form can be fully customized with your hospital's colors, logo, and messaging, and responses can integrate directly with tools like Google Sheets, Airtable, Slack, or your existing patient management platform via Stepper.

Start gathering actionable patient feedback today with this professional, HCAHPS-aligned survey template.

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Kenyon.png
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adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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