Used 2,000+ times

在患者第一次就診之前,事先了解他們的整體健康狀況,這樣可保持貴診所運作順暢。

SurveyMonkey is rated 4.5 out of 5 from 18,000+ reviews on G2.com

請注意:若 1996 年美國健康保險可攜性與責任法案 (HIPAA) 適用於您和您應用 SurveyMonkey 的方式,則只有在滿足下列條件的情況下,您才能使用此範本 1) 擁有「已啟用 HIPAA 功能」的 SurveyMonkey 帳戶,並且 2) 與我們簽訂商業夥伴協議 (請聯絡我們的銷售團隊以進行購買)。請閱讀我們的合理使用政策以瞭解更多資訊。

在病患初診之前就調查他們的整體健康狀況,這麼做有助於貴診所運作順暢。只要將這份調查問卷範本寄給病患,診所員工就能快速看出待處理的問題並判斷先後緩急。事先瞭解病患的基本健康情況也能為他們省下寶貴的時間,不用在就診當天還得花時間填寫紙本問卷。

這份範本會詢問病患的運動量、吸菸和飲酒習慣,以及每晚睡眠時間多長,還會收集病患的身高體重資訊,以便評定他們的 BMI,以上資料全都可以在他們踏入診所前就收集完畢。提早取得這些資訊能使貴診所運作起來更有效率,也能確保員工事先知道應優先處理哪些事情。

若要使用這份健康狀況調查問卷範本,請註冊或登入 SurveyMonkey。

We have so many powerful features to help you launch surveys quickly, but here are our most popular ones for new users.

Out-of-the-box themes, accessible color palettes, custom fonts, branding, and more.

Collect survey responses via email, website, SMS, social media, QR codes, offline, and more.

Automatic results summaries, filters, custom dashboards, crosstab reports, text analysis, & more.

Flower shop owner looking at his phone, next to a review showing 5 out of 5 stars

Read about our customers, explore webinars, and get guides on collecting feedback in your industry.

Woman reading research blog posts on a tablet, next to four blue and green bar charts

Get tips on how to create better surveys, hear the latest product news, or check out our research.

Man wearing headphones and using a laptop, next to an image of SurveyMonkey's logo

Access tutorials on how features work, learn more about billing, and contact Customer Support.