Assign from

More about Clinic Evaluation Survey

Every time patients visit a clinic, their experiences determine whether this visit will be their last, or one of many more. To keep up with patients’ needs and expectations, regular feedback collection can be a critical part of the processes and procedures in your medical clinic.

The Clinic Evaluation Survey offers a simple way to measure and track basic aspects of the patient experience like reason for visit, wait time, clarity of communication, friendliness of staff, and quality of facilities. The survey asks for feedback on satisfaction with both the doctor/care provider and with the overall experience, as well as likelihood of returning and recommending the clinic to others. Such data can make a huge difference in addressing patient needs in real time and in making plans for future improvements.

Take care of your patients, but take care of your clinic, too. Diagnose any issues before they develop into a more serious condition, and you’ll be glad you did.


Hospital Billing Feedback

Following a hospital visit, this form can be used to collect feedback regarding patients' experience with the billing process.

Read More


Hospital Patient Satisfaction Survey

This survey gathers information to understand a patient's satisfaction after a hospital visit, including how patients feel the staff cared for them, their experience with aftercare, and their overall satisfaction.

Read More


Hospital Performance Evaluation

This survey asks recent hospital patients for feedback on their satisfaction with their hospital visit, including hospital staff.

Read More

Please email us at or fill out this form and we will contact you shortly.

 Yes No


Please call +1 (800) 646-0520 or fill out this form and we will contact you shortly.