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Patient portal survey template

Find out if your portal works, for the task patients came to do

Four questions for the moment a patient logs out: how easy logging in was, what they came to do, whether they managed it and how safe their information feels. Use it as it is or change any question, and Usertick reads every response for urgency and customer risk.

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What this patient portal survey tells you

A patient portal survey asks the people who use your portal whether it lets them do what they came for: see results, book or change an appointment, renew a prescription, message the practice or pay a bill. This template asks four questions in about half a minute, starting with the login, where a portal visit can stall before it begins.

It is written for the page patients see after they log out, as a website popup set to show on that page alone. The script must be on the portal's own domain; when the portal is a hosted product you can't add a script to, share the survey link in your portal emails or on your website instead.

Results shows the login ease score, the share of each task with the typed Other answers listed, the share who managed what they came to do and the average confidence that their information is safe. Select a task to narrow the whole page to the patients who came for it and see how they did.

On your websiteAs a linkIn an emailAs a conversation
Questions
4
Time to answer
Under a minute
Written for
After logging out of the patient portal, as a website popup
Plans
Every plan, the free plan included

See it on every channel

The same template on your website, behind a link, in an email and as a conversation.

On your website

Show it as a popup, a side button or inside the page, and choose the pages and the moment it opens: on page load, after a delay, on scroll or as someone is about to leave, on every plan. Event and behavior triggers work on 1 survey on Free and on every survey from Starter.

The 4 questions, one by one

What each question asks, why it is there, what it shows you and what to change.

Question 1 of 4 · Customer effort

How easy was it to log in to the portal?

Why ask it
Logging in is the first step of every portal task, and a forgotten password or a confusing verification step can end the visit there. A 1 to 7 effort scale shows how much work it took.
What you learn
The average on the 1 to 7 scale and the share who found it easy, with a hard-to-easy bar, against the period before.
Make it yours
Patients who never got in never reach the logout page, so add a second short survey on the sign-in page with the exit intent trigger to hear from them.
Question 2 of 4 · Multiple choice · Optional

What did you come to do today?

Why ask it
Knowing what patients came to do turns the next question into a success rate per task. Patients can pick more than one, and the write-in Other shows tasks you didn't plan for, such as downloading a form.
What you learn
Bars with the share and count of each task, the typed Other answers listed beside them, and the stacked shares over time. Select a task to narrow the page to the patients who came for it.
Make it yours
Match the options to your own portal's menu, using the names patients see there.
Question 3 of 4 · Yes / No

Were you able to do it?

Why ask it
It is the plainest measure of whether the portal works: a patient who couldn't finish calls the front desk instead. Read with the task question, it shows which task fails most.
What you learn
The share that said yes, against the period before. Select No to see which tasks those patients came for and how they rated the login.
Make it yours
On every plan, a workflow can post every No to Slack or Microsoft Teams, so the team that runs the portal sees each visit that went wrong.
Question 4 of 4 · Big scale

How confident are you that your information is safe here?

Why ask it
Patients who doubt the portal is safe go back to phone calls and paper. The question measures how safe it feels, which clearer sign-in steps and plain words about how data is protected can change.
What you learn
The average and a column per step from 1 to 10, compared with the period before, so a change to the sign-in steps shows up in the next period.
Make it yours
Select the lowest columns to see whether those patients also found the login hard, since a confusing login can feel unsafe.

What the answers show

Results turns each question into numbers you can follow week by week.

How easy was it to log in to the portal?

The average on its own scale and the share who found it easy, against the period before and by device.

What did you come to do today?

The share of each answer with its count. Select an answer to narrow the whole page to those people and read what else they said.

Use this template in four steps

From the template to the first answers.

  1. 1

    Open the template

    Sign up free and pick Patient portal in the template gallery. It opens in a matching style, ready to change.

  2. 2

    Make the questions yours

    Reword any question, change the options, and add logic or more questions.

  3. 3

    Choose where it runs

    Show it on your website, send it by email, share its link and QR code, or switch it to a conversation.

  4. 4

    Publish and read the answers

    Answers arrive in Results and the inbox as people send them, each written one read and filed by Usertick.

Tips for this survey

Small choices that keep people answering and the answers useful.

  1. 01

    Target the logout page

    Set the popup to open on page load on the page patients land on after logging out, and target no other page, so nobody is interrupted in the middle of a task.

  2. 02

    Ask the patients who gave up

    A logout survey only hears from patients who got in. A second survey on the sign-in page with the exit intent trigger reaches the ones who left before they could.

  3. 03

    Ask again as the portal changes

    The survey shows until a patient answers once. Set it to show again after a number of days to hear from regular users after each portal update.

  4. 04

    Ask about tasks, never contents

    Ask what patients came to do, never what their results or prescriptions said. Usertick's terms don't allow medical details in surveys, and Usertick doesn't sign business associate agreements.

Customer effort scorePatient satisfaction surveysWebsite surveysPatient portal questions

More customer effort templates and questions

Templates like this one, and single questions from the library to add to it.

Templates

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Customer effortTelehealth visitFind out how easy it was to join a video visit and whether patients would choose one again. Send it right after the call ends.
Customer effortLab testMeasure the lab experience from booking to results, including waits at the lab. Send it once results are released.
Customer effortVaccination clinicLearn how easy it was to get an appointment, how long people waited and whether aftercare information was clear. Send it the day after the appointment.
Customer effortPrescription refillMeasure how easy prescription refills are to request and how long they take to be ready. Send it once the refill is picked up or delivered.

Questions from the library

Browse the question library
  1. How easy is the patient portal to use?Customer effort · Patient portal
  2. What did you use the portal for?Multiple choice · Patient portal
  3. Could you finish without calling us?Yes / No · Patient portal
  4. Split 100 points across what mattered most in your carePoints allocation · Maternity care
  5. Did you have a birth plan you could talk through?Yes / No · Maternity care
  6. Were your questions answered without you having to push?Yes / No · Maternity care

Frequently asked questions

On the page patients see after they log out, as a popup that opens on page load. The script must be on the portal's own domain; if it can't be added, share the survey link in your portal emails instead.

Few enough that a patient on the way out still answers. This template asks four and takes about half a minute.

Until they answer once, by default. To track the portal over time, set it to show again after a number of days, such as 90, so regular users answer a few times a year.

Select No on the third question and look at which tasks those patients came for. Fix the task with the most No answers first, then watch the share that said yes in the next period.

Yes. The same script works in web apps and single-page apps. Usertick doesn't show surveys inside phone apps, so a portal's phone app opens the survey's link instead.

Yes. Every template comes with every plan, the free plan included, and the free plan covers 150 responses a month across your surveys.

Yes. The template becomes your own survey, so reword any question, add or remove questions, and change the options and the logic. The gallery stays as it is.

Yes, from Starter. The template is written in US English. Add languages by hand or with AI translation, and each person sees the survey in their browser's language.

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