Clinic staff survey template
Workload, staffing, safety culture, teamwork and support for clinical and non-clinical staff, anonymously.
4 questions · about 4 minutes to complete · free on every plan
Free account required. The template is copied into your workspace; edit anything before publishing.
- When to use it
- Twice a year.
- Who it is for
- All staff at a practice or unit, anonymously.
How to use this template
- Keep it anonymous unless you need to follow up, and say so in the intro.
- Report by unit only with at least ten responses.
- Share what you learned and one change you made. People answer the next survey when the last one visibly mattered.
Questions in the clinic staff survey template
1. Your role
single choice · Clinical, Nursing or allied health, Administrative, Management, Other
2. Please rate your agreement:
matrix · Staffing levels are adequate for safe care, I can raise safety concerns without fear, Teams communicate well at handover, My manager supports me, I have the training I need, My workload is manageable
3. Do you see yourself working here in two years?
single choice · Yes, Probably, Not sure, Probably not, No
4. What one change would most improve patient care here?
open text
What the results look like
IllustrativeSynthetic sample of 120 responses generated for this preview, not real survey data. Your results page shows the same charts for your own responses.
1.Your role
120 answered| Answer | Count | Percent |
|---|---|---|
| Clinical | 35 | 29% |
| Nursing or allied health | 9 | 8% |
| Administrative | 40 | 33% |
| Management | 13 | 11% |
| Other | 23 | 19% |
2.Please rate your agreement:
120 answered| Statement | Strongly disagree | Disagree | Neutral | Agree | Strongly agree | n |
|---|---|---|---|---|---|---|
| Staffing levels are adequate for safe care | 6% | 12% | 19% | 31% | 33% | 120 |
| I can raise safety concerns without fear | 11% | 13% | 17% | 28% | 31% | 120 |
| Teams communicate well at handover | 13% | 17% | 19% | 20% | 32% | 120 |
| My manager supports me | 8% | 12% | 16% | 28% | 36% | 120 |
| I have the training I need | 8% | 11% | 18% | 29% | 34% | 120 |
| My workload is manageable | 10% | 10% | 20% | 30% | 30% | 120 |
3.Do you see yourself working here in two years?
120 answered| Answer | Count | Percent |
|---|---|---|
| Yes | 14 | 12% |
| Probably | 28 | 23% |
| Not sure | 21 | 18% |
| Probably not | 14 | 12% |
| No | 43 | 36% |
How to read these questions
- single choice: Read the share choosing each option, then cross-tab by a segment question to see who differs.
- matrix: Compare rows on the same column (for example, % agree) to find the weakest statement, then look at who rates it lowest.
Frequently asked questions
How do I survey clinical staff without adding to their workload?
Five minutes maximum, mobile-first, open for two weeks, and visibly act on the last one.
How long does the clinic staff survey take to complete?
About 4 minutes: 4 questions, most of them single-tap. Every question can be edited, removed or reordered in the builder before you publish.
Is this template free to use?
Yes. Every template is included on the Free plan. Sign up, click Use this template, and it is copied into your workspace where you can edit it, add your logo and share it by link, email or embed.
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