Customer Survey Report template
A form in the Complaints and Feedback procedure (PR06), mapped to ISO 15189:2022 clause 8.6. Fill it in whenever the task occurs. Used by the quality-management team.
FormISO 15189 · 8.6As needed
Calculated automatically
Your LaboratoryCustomer Survey Report | YL-QM-FRM-06-F04 v1.0
Form: Customer Survey Report
Survey period
Method (paper / online)
Prepared by
Users surveyed (clinicians, patients, wards) (distributed)
Responses received
Response rate %auto
| No. | Survey area | Very satisfied | Satisfied | Neutral | Dissatisfied | Very dissatisfied | Responses | % satisfied | Target met? |
|---|---|---|---|---|---|---|---|---|---|
| 1 | Ease of requesting tests | ||||||||
| 2 | Sample collection experience | ||||||||
| 3 | Turnaround time | ||||||||
| 4 | Report clarity and content | ||||||||
| 5 | Communication of critical results | ||||||||
| 6 | Courtesy and professionalism of staff | ||||||||
| 7 | Advisory / consultation service | ||||||||
| 8 | Handling of complaints | ||||||||
| 9 | Overall satisfaction |
| Key findings |
|---|
| Improvement actions (enter in PR10-F01 / PR10-F03) |
|---|
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Prepared by (Quality Officer) | |||
| Reviewed by (Laboratory Manager) |
Shaded cells are calculated automatically.
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
A4 landscape · first page · showing 9 of 9 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Survey area
- Very satisfied
- Satisfied
- Neutral
- Dissatisfied
- Very dissatisfied
- Responses
- % satisfied
- Target met?
Sign-off
- Prepared by (Quality Officer)
- Reviewed by (Laboratory Manager)
Related templates
- Customer Complaint Form (PR06-F01)
- Complaints Register (PR06-F02)
- Customer Satisfaction Survey Form (PR06-F03)
- Personnel Feedback Form (PR06-F05)
- Personnel Feedback Report (PR06-F06)
- Staff Suggestion Form (PR06-F07)
- Staff Suggestion Log (PR06-F08)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.