Facility Cleanliness Feedback
Gathers opinions on the cleanliness and hygiene of the healthcare facility, ensuring a safe and comfortable environment for patients.
Survey Preview
Date *
How satisfied are you with the overall cleanliness of the facility? *
Terrible
Bad
Ok
Good
Great
How clean and well-maintained was the waiting area? *
How satisfied are you with the cleanliness of the exam room or treatment area? *
How well did the staff follow cleanliness protocols (e.g., hand hygiene, equipment cleaning)? *
How clean were the restrooms and common areas of the facility? *
How frequently did you notice cleaning and sanitizing during your visit? *
How comfortable did you feel about the hygiene standards of the facility? *
How satisfied are you with the overall appearance and upkeep of the facility? *
Terrible
Bad
Ok
Good
Great
How likely are you to return based on the facility’s cleanliness? *