Survey

Appointment Feedback Survey

1 page•10 fields
Editable templateCustomize in minutes

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formisoft.com/f/appointment-feedback

Appointment Feedback Survey

Page 1 of 1

Scheduling Ease
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
Not applicable
Appointment Availability
Excellent
Good
Fair
Poor
Very poor
Not applicable
Pre-Visit Communication
Excellent
Good
Fair
Poor
Very poor
Not applicable
Check-In Experience
Excellent
Good
Fair
Poor
Very poor
Not applicable
Wait Time Rating
Excellent
Good
Fair
Poor
Very poor
Not applicable
Waiting Room Comfort
Excellent
Good
Fair
Poor
Very poor
Not applicable
Staff Communication About Delays
Excellent
Good
Fair
Poor
Very poor
Not applicable
Check-Out Process
Excellent
Good
Fair
Poor
Very poor
Not applicable
Overall Appointment Rating
Excellent
Good
Fair
Poor
Very poor
Not applicable
Suggestions for Improvement
Enter details here...
Submit
Use this template

Sign up and start customizing in minutes.

Start with the Appointment Feedback Survey template and tailor it to your practice. It includes 10 editable fields across 1 page. Included questions: Scheduling Ease, Appointment Availability, Pre-Visit Communication, Check-In Experience. The full field list below shows what you will get when you add this template to your account.

Choose this template to open an editable form. Review the questions, keep only the information your practice needs, and add your branding. Preview the patient experience before sharing a link or embedding the form. Responses can be reviewed in Formisoft and exported as a PDF.

What's included

  • Scheduling Ease
  • Appointment Availability
  • Pre-Visit Communication
  • Check-In Experience
  • Wait Time Rating
  • Waiting Room Comfort
  • Staff Communication About Delays
  • Check-Out Process
  • Overall Appointment Rating
  • Suggestions for Improvement

Who uses this template

  • Primary care and specialty practices optimizing patient flow
  • Dental offices improving scheduling and wait time efficiency
  • Outpatient centers evaluating check-in and check-out processes
  • Practice managers making data-driven operational improvements

All form fields

10 fields across 1 page. Customize any field after signing up.

Scheduling EaseMultiple Choice
Appointment AvailabilityMultiple Choice
Pre-Visit CommunicationMultiple Choice
Check-In ExperienceMultiple Choice
Wait Time RatingMultiple Choice
Waiting Room ComfortMultiple Choice
Staff Communication About DelaysMultiple Choice
Check-Out ProcessMultiple Choice
Overall Appointment RatingMultiple Choice
Suggestions for ImprovementLong Text

How to use the Appointment Feedback Survey

Getting started with this template takes just a few minutes. Sign up for a Formisoft trial, then select the Appointment Feedback Survey from the template library. Review the included questions, customize your fields, and preview the form before sharing it.

Setup steps

  1. 1Choose the template. Find the Appointment Feedback Survey in the template library and click “Use this template” to add it to your account.
  2. 2Customize fields. Add, remove, or reorder any of the 10 fields. Set fields as required or optional based on your practice needs.
  3. 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
  4. 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
  5. 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.

Frequently asked questions

How does Formisoft protect responses?

Formisoft provides secure form collection and a Business Associate Agreement (BAA). Your practice must review the form content, access permissions, and sharing workflow for its requirements.

Can I customize the fields in this template?

Absolutely. You can add, remove, reorder, or modify any of the 10 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

How do patients fill out this form?

Patients receive a link via SMS, email, or QR code. They complete the form on their phone, tablet, or computer before their appointment. No app download required.

Can I send this form automatically before appointments?

With a plan that includes automation, you can configure workflows to send forms and reminders. Appointment-based sending requires the booking event to reach Formisoft.

Does this template work on mobile devices?

Yes. The Appointment Feedback Survey is fully responsive and works on any device. Most patients complete intake forms on their phone, so every template is optimized for mobile-first use.

Start with this template

Sign up and start customizing the Appointment Feedback Survey for your practice. Set up in minutes.

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