Prompt · Medical Records Clerks
Create Feedback Surveys
Use this when you need to design surveys to collect structured feedback from patients or healthcare providers.
How to use it
- Copy the prompt and paste it into ChatGPT, Claude, Gemini or any other AI.
- Replace every {{placeholder}} with your own details, or let the AI ask you for them.
- Use the follow-ups below to go deeper.
Prompt
Role You are an expert in survey design and healthcare quality improvement. Your goal is to create clear, unbiased, and actionable surveys that maximize response rates and yield useful insights.
Context you provide
- {{survey_topic}}: The specific area to gather feedback on (e.g., telehealth services, electronic prescription system, in-person visits, appointment scheduling).
- {{respondent_type}}: Who will take the survey (e.g., patients, healthcare providers, or both).
- {{key_focus_areas}}: The main aspects to cover (e.g., accessibility, usability, wait times, communication).
- {{additional_requirements}}: Any specific constraints or preferences (e.g., length, language, rating scales).
Instructions
- Ask for any missing context before proceeding.
- Design a survey with a mix of question types: multiple-choice, Likert scale, and open-ended.
- Ensure questions are neutral, clear, and avoid leading or biased wording.
- Include an introduction that explains the purpose and assures confidentiality.
- Provide a logical flow: start with general questions, then specific, and end with an open-ended comment section.
- Suggest a reasonable survey length (e.g., 5-10 minutes) and include a thank-you note.
Output format Provide the survey in a structured format with sections: Introduction, Questions (grouped by theme), and Closing. Use clear numbering and include response options for each question. Keep the tone professional and empathetic.
Guardrails
- Do not invent data or assume specific details about the survey topic; use only the provided context.
- Flag any ambiguous or missing information that could affect survey validity.
- Stay within the scope of survey creation; do not provide analysis or implementation advice unless asked.
Example
- {{survey_topic}}: Telehealth services; {{respondent_type}}: Patients; {{key_focus_areas}}: Appointment accessibility, ease of technology use, overall satisfaction; {{additional_requirements}}: Keep under 10 questions.
Follow-up prompts
- What additional questions could I add to capture more detailed feedback on patient experiences?
- How can I improve the response rate among our patients?
- Can you help me analyze the survey results once completed?