Net Promoter Score (NPS) Survey
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Net Promoter Score (NPS) Survey
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The Net Promoter Score (NPS) Survey provides a fast, industry-standard method for measuring patient loyalty and likelihood to recommend your practice to others. Built around the classic NPS question on a 0-to-10 scale, this template automatically segments respondents into Promoters (9-10), Passives (7-8), and Detractors (0-6), giving you a single powerful metric that correlates with patient retention and organic growth. The brevity of this survey maximizes response rates while still capturing the most actionable loyalty data available.
Beyond the core NPS question, this survey includes a follow-up asking the patient to select the primary reasons behind their score from a curated list of common satisfaction drivers and detractors. Options include provider quality, staff friendliness, wait times, facility environment, billing experience, and care outcomes. An open-ended comment field invites the patient to elaborate in their own words, providing the qualitative context that transforms a number into an actionable insight. A final question captures how long the patient has been with the practice, enabling you to segment NPS by patient tenure.
This template is ideal for any healthcare organization that wants a lightweight, repeatable satisfaction metric that can be tracked monthly or quarterly. Practices use NPS to set organizational goals, compare performance across locations or departments, identify at-risk patients before they leave, and celebrate wins when scores improve. The simplicity of the survey makes it easy to integrate into automated post-visit workflows, ensuring consistent data collection without survey fatigue.
What's included
- Standard 0-10 Net Promoter Score recommendation question
- Automatic Promoter, Passive, and Detractor segmentation
- Satisfaction driver and detractor reason selection
- Open-ended fields for qualitative praise and improvement suggestions
- Patient tenure capture for loyalty trend analysis
- Contact permission for follow-up on detractor feedback
Who uses this template
- Healthcare organizations tracking a single loyalty metric over time
- Multi-location practices comparing NPS across sites and departments
- Marketing teams identifying promoters for testimonials and referrals
- Operations leaders detecting detractor trends before patient churn
All form fields
9 fields across 1 page. Customize any field after signing up.
How to use the Net Promoter Score (NPS) Survey
Getting started with this template takes just a few minutes. Sign up for a free Formisoft trial, then select the Net Promoter Score (NPS) Survey from the template library. The form is ready to use immediately, but you can customize every field, add your practice logo, and adjust the layout to match your workflow.
Setup steps
- 1Choose the template. Find the Net Promoter Score (NPS) Survey in the template library and click “Use this template” to add it to your account.
- 2Customize fields. Add, remove, or reorder any of the 9 fields. Set fields as required or optional based on your practice needs.
- 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
- 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
- 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.
Frequently asked questions
Is the Net Promoter Score (NPS) Survey HIPAA compliant?
Yes. All Formisoft templates, including the Net Promoter Score (NPS) Survey, are HIPAA compliant. Data is encrypted with 256-bit AES at rest and TLS 1.3 in transit. A Business Associate Agreement (BAA) is included on every plan.
Can I customize the fields in this template?
Absolutely. You can add, remove, reorder, or modify any of the 9 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?
Yes. Formisoft's workflow automation can send intake forms automatically when an appointment is booked. You can set the timing (e.g., 48 hours before the visit) and include reminders for patients who haven't completed it.
Does this template work on mobile devices?
Yes. The Net Promoter Score (NPS) 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 Net Promoter Score (NPS) Survey for your practice. Set up in minutes.
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