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Free Practice NPS Survey Template

Free therapy practice NPS survey — the 0-10 recommend score plus a mandatory verbatim reason, with routing for detractors and promoters.

~2 min
0-10 + why
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Quick answer

Free therapy practice NPS survey — the 0-10 recommend score plus a mandatory verbatim reason, with routing for detractors and promoters.

Disclaimer: this survey collects service-experience feedback for improvement. It is not a clinical measure; concerns in responses should follow your complaints and safeguarding procedures.

Content note: routing bands are a starting convention — tune thresholds to your caseload context.

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About this template

Therapy practices grow or shrink on word of mouth nobody measures. This NPS survey asks the one recommend question on 0-10, requires the reason in the client's own words, and routes answers: detractor feedback to improve, promoters to gentle review asks. Quarterly aggregates turn whispers into a signal you can act on.

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Live Preview

Fillable sample survey preview (live once the app is published).

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Fill it in to see how responses flow.
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What's Included

The recommend score and reason prompts behind NPS.

1

One anchor score

The classic recommend question on 0-10.

2

Reason required

Scores without words are noise.

3

Detractor routing

Low scores flag for follow-up or review.

4

Promoter conversion

Turn 9s and 10s into reviews.

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How It Works

From copy to an NPS reading in four steps.

1

Copy the template

Import the NPS survey into your workspace — free.

2

Set your routing

Follow-up rules for each score band.

3

Send at natural points

After positive reviews or course end.

4

Act and re-measure

Fix the top complaint, watch the trend.

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Who Is This For

Who runs it — practice owners measuring client loyalty.

1

Practice owners

Therapy growth is word of mouth — measure it.

2

Clinic managers

A quarterly reputation signal.

3

Marketing leads

Review-ready promoters identified honestly.

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Key Features

What makes this NPS survey actionable, not just a number.

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Sample Questions Inside

A preview of the real items — adapt routing and asks to your practice.

  1. How likely are you to recommend this practice to someone you care about? (0-10)
  2. What is the main reason for that score? (required, open)
  3. Was there anything that nearly stopped you coming back? (open)
  4. Would you be open to writing a short review? (y/n)
  5. Anything you want the practice to fix first? (open)
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Frequently Asked Questions

Is NPS meaningful for a therapy practice?
Yes — with a required reason line; a bare 0-10 is vanity, but recommend-or-not plus verbatim reason is the closest proxy to word of mouth you can systematically collect.
Who gets surveyed, and when?
Client-course completions and positive review points, not mid-therapy; and never in active crisis.
What do I do with a low score?
Route detractors to follow-up only when anonymous-in-name answers allow it; otherwise treat it as aggregate signal and act on the stated reason.
Is it free to use?
Yes — copy it into your FormLM workspace at no cost and set your routing.
Should clients expect it?
Yes — say why you ask; practices that explain the ask get better reasons.
How is this different from a satisfaction survey?
Satisfaction asks how they felt about services; NPS asks what they would do for you — different questions predict different growth.
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Related templates in this category

New Client Intake Form Pre-Consultation Form Mental Health History Form Symptom Self-Assessment Medication & Allergy Form Referral Source Form

Measure the whisper network

One recommend score plus the verbatim reason — the honest reputation loop. Free.