Patient Satisfaction Survey for a Telehealth Visit

Job Aid
Patient Experience Telehealth Title X Family Planning Program
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Title X agencies, like other health care providers, have responded to a growing demand for telehealth services. It is crucial to ensure that patients are satisfied with services provided via telehealth and to learn more about their experiences with care.

Use this sample patient satisfaction survey to get feedback from patients about how they feel about the services they received during a telehealth visit. To ensure that all patients have the opportunity to complete the survey, agencies should draw from their existing systems and protocols to address literacy level, vision challenges, and other factors influencing accessibility such as survey translation.

This resource is a part of the Patient Experience Improvement Toolkit.