Templates › Surveys › SEO page

Run: Family Satisfaction Survey – Senior Living

A family satisfaction survey for senior living communities that measures care quality, communication, safety, and overall experience from the resident family...

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Overall Experience & Recommendation

How likely are you to recommend this community to a friend or family member seeking senior care? (required)

Rate on a scale of 1–5: 1 = Very unlikely, 3 = Neutral, 5 = Very likely (eNPS-aligned)

Overall, how satisfied are you with the care and services your loved one receives at this community? (required)

1 = Strongly dissatisfied, 3 = Neutral, 5 = Strongly satisfied

If you rated overall satisfaction 3 or below, please tell us what is most driving that score.

Your candid feedback helps us prioritize the right improvements. All responses are anonymous.

Compared to when your loved one first moved in, how would you describe the quality of care today?

Select one: Much better / Somewhat better / About the same / Somewhat worse / Much worse

Care Quality & Clinical Services

Staff treat my loved one with dignity, respect, and compassion. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

My loved one's personal care needs (bathing, grooming, dressing) are consistently met. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Medication management is handled accurately and on schedule. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

When my loved one has a health concern or change in condition, staff respond promptly and appropriately. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Please share any specific care quality concerns or compliments you'd like us to know about.

Optional — your details help us recognize excellent staff and address gaps.

Communication & Family Partnership

Staff keep me informed about important changes in my loved one's health, behavior, or care plan. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

When I contact the community with a question or concern, I receive a timely and helpful response. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

I feel like a valued partner in my loved one's care planning and decisions. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Which communication channels do you currently use to stay connected with the community?

Select all that apply: Phone calls / Email / In-person visits / Community app or portal / Newsletters / Care plan meetings

Yes No N/A

What would make communication between you and our team more effective or convenient?

Suggestions welcome — e.g., preferred frequency, format, or topics.

Safety, Environment & Amenities

I feel confident that my loved one is safe and secure in this community. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

The community is consistently clean, well-maintained, and free of unpleasant odors. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Dining options meet my loved one's nutritional needs and personal preferences. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Activities and social programming provide meaningful engagement for my loved one. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Staff & Leadership

Staff members know my loved one as an individual — their preferences, history, and personality. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree (person-centered care indicator)

The community's leadership team is visible, approachable, and responsive to family concerns. (required)

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Staff turnover has NOT negatively affected the consistency of care my loved one receives.

1 = Strongly disagree, 3 = Neither agree nor disagree, 5 = Strongly agree

Is there a specific staff member you would like to recognize for exceptional care or service?

Optional — recognition is shared with the team (this response may not remain anonymous if a name is mentioned).

Open Feedback & Optional Demographics

What does this community do best? What should we protect and never change?

Strengths are as important to understand as areas for improvement.

What is the single most important improvement we could make to better serve your loved one and your family?

Please be as specific as possible — your input directly shapes our quality improvement priorities.

Is there anything else you would like us to know?

Any additional thoughts, concerns, or compliments are welcome.

How long has your loved one been a resident of this community?

Optional — helps us understand satisfaction trends by tenure. Less than 3 months / 3–12 months / 1–2 years / 3–5 years / More than 5 years

What level of care does your loved one currently receive?

Optional — Independent Living / Assisted Living / Memory Care / Skilled Nursing / Respite / Other

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Generated with MangoApps Templates — browse 250+ free