Hospital Services example

This is an example Hospital Services survey. This survey includes questions like:

We hope this will help you create your own Hospital Services survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

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1) How long have you been using the services of this hospital?

Please tell us how satisfied you are with each of the following.

2) How satisfied are you with the cleanliness of the doctor's prep rooms?
3) How satisfied are you with the cleanliness of the surgical suites?
4) Surgical Nurses?
5) General Nursing Staff?
6) Laboratory Services?
7) Patient rooms?
8) Availability of surgical suites?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
9) Out-Patient testing facilities?
10) Radiology facilities?
11) Overall, how satisfied are you with the services provided at this hospital?
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