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Vaccination clinic survey template

Run a smoother clinic day, from booking to aftercare

Four questions for the day after a vaccination appointment: how easy it was to get one, how long people waited, whether the side effects information was clear and how satisfied they were overall. 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 vaccination clinic survey tells you

A vaccination clinic survey asks about the logistics around the shot: finding and booking an appointment, waiting on the day and the information people take home about possible side effects. This template asks four questions in about half a minute and never asks which vaccine someone had.

It is written for the day after the appointment, sent by Usertick email to the people booked that day, when they can judge both the visit and the information they took home. The same survey runs on your booking confirmation page or as a QR code on the aftercare leaflet for people who walked in.

Results shows the booking ease score with the share who found it easy, the median wait with the middle half of answers, the share who found the side effects information clear and the satisfaction average with the share of 4s and 5s. Every card compares with the period before, so a busy season shows up beside a quiet one.

In an emailAs a linkOn your websiteAs a conversation
Questions
4
Time to answer
Under a minute
Written for
The day after the appointment, by email to the people booked that day
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.

In an email

Send it from Usertick to a contact list, with the first question inside the email. A tap on an answer opens the rest of the survey with that answer already kept. Usertick sends 50 emails a month on the free plan, or connect your own sender.

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 get an appointment?

Why ask it
When slots are scarce or booking is hard, people give up before they reach the clinic. A 1 to 7 effort scale measures how hard it was to get a slot.
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
Keep it first, so people answer inside the email with one tap and the rest of the survey opens with it kept.
Question 2 of 4 · Ruler · Optional

How long did you wait on the day?

Why ask it
The shot itself takes a minute, so the wait on the day is most of the visit. A ruler from no wait to 45 minutes or more lets people drag to roughly how long it was.
What you learn
The median wait and the middle half of answers drawn over the scale, compared with the period before, so the effect of an extra station or a new booking window shows up.
Make it yours
Change the open top end to fit your clinic, such as 90+ min for a large clinic day.
Question 3 of 4 · Yes / No

Was the information about possible side effects clear?

Why ask it
The information people take home decides whether they know what is normal afterward and when to call. The question checks that the leaflet or the explanation worked, without asking about any reaction.
What you learn
The share that said yes, against the period before. Select No to see whether those people also waited longest, which can point to a rushed explanation.
Make it yours
When the share drops, rewrite the leaflet in plain words and check the share in the next period.
Question 4 of 4 · Stars

Overall, how satisfied are you with your visit?

Why ask it
The overall rating comes last here, after people have thought through the booking, the wait and the information, so it sums up the whole visit.
What you learn
The average, a bar per rating and the share who rated 4 or 5, compared with the period before.
Make it yours
Add an optional text question after it when you want the reason behind low ratings, and Usertick files each answer under a category such as waiting times.

What the answers show

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

How easy was it to get an appointment?

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

Use this template in four steps

From the template to the first answers.

  1. 1

    Open the template

    Sign up free and pick Vaccination clinic 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

    Send it the next morning

    Schedule the send for the morning after the clinic, so the email arrives while the visit is fresh. Usertick schedules sends up to 30 days ahead.

  2. 02

    Give each site its own survey

    When you run clinics in several places, make one survey per site or add a question that names it, since Results doesn't split answers by the tag on a link.

  3. 03

    Keep reactions out of the survey

    Ask whether the information was clear, never how the person reacted. Usertick's terms don't allow medical details in surveys, and Usertick doesn't sign business associate agreements.

  4. 04

    Reach walk-ins with a QR code

    People who walk in without booking may not be on your contact list, so print the QR code on the aftercare leaflet or a sign by the exit.

Customer effort scorePatient satisfaction surveysEmail surveysMaternity care questions

More customer effort templates and questions

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

Templates

Browse all templates
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 effortPatient portalMeasure how easy your patient portal is to use and whether people could finish what they came to do. Show it after a patient logs out.
Customer effortLab testMeasure the lab experience from booking to results, including waits at the lab. Send it once results are released.
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. Split 100 points across what mattered most in your carePoints allocation · Maternity care
  2. Did you have a birth plan you could talk through?Yes / No · Maternity care
  3. Were your questions answered without you having to push?Yes / No · Maternity care
  4. How many hours were you there in total?Ruler · Urgent care visits
  5. How did you decide to come in?Multiple choice · Urgent care visits
  6. Were you told how long the wait would be?Yes / No · Urgent care visits

Frequently asked questions

The day after the appointment. People have had time to read the aftercare information and still remember the wait.

Four or five. This template asks four and takes about half a minute.

Print the survey's QR code on the aftercare leaflet or a sign by the exit. It opens the hosted survey page in their phone browser.

Yes, by link or QR code with anonymous responses turned on. Usertick email ties each answer to the person's contact, so share the link when anonymity matters.

Usertick sends 50 survey emails a month on Free, 500 on Starter, 2,500 on Pro and 10,000 on Business. You can also connect your own sender, which has no allowance.

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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