A treatment satisfaction questionnaire is good enough a process to judge any treatment, its benefits, demerits, utility of the treatment and lots more. A set of such questions can reveal the satisfaction of a person undergoing any particular treatment.

Sample Treatment Satisfaction Questionnaire

Name: __________________________

Treatment Undergoing: ____________________

Period of Treatment: _____________________

Age: _____________________________

Contact Details: _________________________

Please mark the options carefully:

Q1. Do you observe any improvement after the treatment?

  1. Their is immense improvement after the treatment
  2. There is no such improvement after the treatment, it is equal to no effect at all
  3. Rate of improvement is very slow, but it is working

Q2. Is the treatment very uncomfortable?

  1. Indeed, treatment is very much uncomfortable
  2. The treatment is very soothing, not uncomfortable at all
  3. Partially it is a bit uncomfortable but still bearable

Q3. Does the treatment worth the charge it is demanding?

  1. I get an absolute pay back of the money.
  2. I do not feel that I get a worth of my money
  3. It is fine if it works for you

Q4. Do you face any side effects after the treatment’s onset?

  1. I am badly affected by the various physiological side effects
  2. This treatment is absolutely side effect free, very much dependable
  3. There are side effects of every treatment, it has to be accepted

Q5. Will you suggest this treatment to any body in future?

  1. Without a doubt I will recommend this treatment in future
  2. I will think twice before recommending
  3. What is good to me may not be satisfying to some one else