Schuylkill Rehabilitation Center is committed to providing high quality therapy services. We wish to obtain your assessment of our services in order to help meet these high standards. Your feedback is an essential component to our strategic planning and outcome data management. We would be more than grateful if you could complete the following questionnaire.

Check each question in a rating from 1(Never) to 7(Always):

1. Were written progress notes beneficial?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
2. Were progress notes:
   
   Timely?
   

   Never				Always
   1	2	3	4	5	6	7

   
   Accurate?
   

   Never				Always
   1	2	3	4	5	6	7

   
   Comprehensive?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
3. When verbal communication about your patients’ progress
   was made, was it beneficial?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
4. Was the first appointment scheduled in a timely manner?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
5. Do you believe your patient(s) improved because of treatment
   at Schuylkill Rehabilitation Center?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
6. Overall, were you satisfied with the services provided by
   Schuylkill Rehabilitation Center?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
7. Will you continue to refer to our services if needed in the future?
   

   Never				Always
   1	2	3	4	5	6	7
   Comment:

   
   
8. Are there other services or additional equipment which Schuylkill Rehabilitation Center could be providing to your patients?
   None at this time
   Yes, please explain:
   
   
9. What outcome information is valuable for you to obtain?
   Percentage of patients who accomplish goals.
   Percentage of patients who return to work.
   Percentage of patients who maximized return to active
         productive life role.
   Efficiency and cost data.
   Effectiveness and duration data.
   Functional levels compared at 90-day follow-up.
   All of the above.
   Other:
   
   
10. How should we communicate our current services and outcome information? Please select one choice from each column:
    

    Brochures Detailed reports

    Mail E-mail Fax

    Annual basis Request only

    
    
11. Please list any additional comments, identify strengths, weaknesses, threats, and opportunities available to Schuylkill Rehabilitation Center which will assist our ongoing quest to improve our quality of services.