Patient Feedback Forms

14 Templates

Patient feedback is important to ensure you’re taking good care of your patients. Whether you work at a doctor’s office, dentist’s office, or other healthcare provider, Jotform’s free Patient Feedback Forms can help you collect feedback seamlessly from any device — great for telemedicine or in-person services! Start by selecting a free template below and customizing it with our drag-and-drop builder. Then embed the form in your website or share it to patients with a link, and view responses in your secure Jotform account.

Feel free to make changes to your chosen Patient Feedback Form template. Drag and drop to add or update questions, upload your logo, or change the form design. All responses are protected with a 256-bit SSL connection and a HIPAA compliance option for healthcare professionals. Once you’ve gathered feedback, you can view it as a spreadsheet or cards in Jotform Tables — or even generate reports in Jotform Report Builder! Switch from paper forms to online forms to collect data fast with free online Patient Feedback Surveys.

Patient Feedback Form

A patient feedback form is a survey with questions that allows medical doctors to gather feedback from patients regarding their overall experience with the clinic.

Patient Feedback Forms

Hypnotherapy Session Feedback

A hypnotherapy session feedback form is a customer feedback survey that allows clients to review the services of a hypnotherapist. Collect feedback online with Jotform!

Healthcare Forms

Dental Patient Feedback Form

A Dental Patient Feedback Form is a form template designed to gather patient feedback regarding their experience with a dentist.

Feedback Forms

Group Therapy Client Feedback Form

A group therapy client feedback form is a feedback survey that allows clients to review the services of a therapist working in a group therapy setting or clinic.

Healthcare Forms

Home Care Feedback Form

A home care feedback form is a survey that allows patients to provide feedback on their experience with home care services.

Healthcare Forms

Mental Health Awareness Feedback Form

A mental health awareness feedback form is used by medical professionals and practitioners to gather feedback from patients about their mental health. It may be used by psychiatrists, psychologists, counselors, social workers, and a variety of other medical professionals.

Feedback Forms

Energy Medicine Treatment Feedback Form

This form aims to collect feedback from customers about Healy Resonance treatments.

Healthcare Forms

Patient Engagement Survey

A Patient Engagement Survey is a form template designed to assess the level of patient engagement, satisfaction, and overall experience with the healthcare services provided.

Healthcare Forms

Patient Exit Survey

A Patient Exit Survey is a form template designed to gather feedback from patients about their experience and satisfaction with the healthcare services they received.

Patient Feedback Forms

IYJ Program Feedback Form Participant

Feedback from about program participation and structure from participant perspective

Feedback Forms

These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.